title: Gastrojejunal Anastomosis Complications and Their Management after Laparoscopic Roux-en-Y Gastric Bypass.
abstract: BACKGROUND
  Complications at the gastrojejunal anastomosis after laparoscopic Roux-en-Y gastric bypass (LRYGB) are challenging in terms of diagnosis, therapy, and prevention. This study aims at identifying these complications and discussing their management.
  
  
  METHODS
  Data of 228 patients who underwent a LRYGB between October 2008 and December 2011 were reviewed retrospectively to evaluate the frequency and treatment of complications such as stenoses, marginal ulcers, perforated marginal ulcers, or anastomotic leaks related to the operation.
  
  
  RESULTS
  Follow-up information was available for 209 patients (91.7%) with a median follow-up of 38 months (range 24-62 months). Of these patients 16 patients (7.7%) experienced complications at the gastrojejunostomy. Four patients (1.9%) had stenoses and 12 patients (5.7%) marginal ulcers, one of them with perforation (0.5%). No anastomotic leaks were reported. One case with perforated ulcer and one with recurrent ulcers required surgical revision.
  
  
  CONCLUSIONS
  Gastrojejunal anastomotic complications are frequent and occur within the first few days or up to several years after surgery. Stenoses or marginal ulcers are usually successfully treated nonoperatively. Laparoscopic repair, meanwhile, is an appropriate therapeutic option for perforated ulcers.
authors.affiliation: Department of Surgery, Hospital of Jura, Faubourg des Capucins 30, 2800 Delémont, Switzerland.
authors.forename: Yannick
authors.initials: Y
authors.lastname: Fringeli
authors.affiliation: Department of Surgery, Hospital of Jura, Faubourg des Capucins 30, 2800 Delémont, Switzerland.
authors.forename: Marc
authors.initials: M
authors.lastname: Worreth
authors.affiliation: Department of Surgery, Hospital of Jura, Faubourg des Capucins 30, 2800 Delémont, Switzerland.
authors.forename: Igor
authors.initials: I
authors.lastname: Langer
mesh_terms: D000293:Adolescent; D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D007579:Jejunal Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010437:Peptic Ulcer / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D010439:Peptic Ulcer Perforation / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000473:pathology / Q000601:surgery*; D012086:Reoperation; D016896:Treatment Outcome