XXXX of gastroenteric anastomotic stricture after laparoscopic gastric bypass.

@entity1 @entity28 @entity384 @entity4 @entity344 @entity850
BACKGROUND AND STUDY AIMS: Laparoscopic gastric bypass is a recently introduced treatment option for morbid @entity28 , with promising initial results. Stenosis of the gastroenterostomy is a recognized complication. The efficacy and safety of @entity384 for the management of this type of @entity850 has not been studied. @entity1 AND METHODS: 450 @entity1 who underwent laparoscopic gastric bypass at our institution were followed prospectively. All @entity1 had a 15 ml gastric pouch and either a 75 cm or 150 cm jejunal Roux limb depending on whether @entity28 was morbid (body mass index (BMI) < 50 kg/m 2) or super-morbid (BMI > 50 kg/m 2). @entity1 who developed symptoms compatible with stenosis of the gastrojejunostomy were referred for upper @entity344 . RESULTS: 14 @entity1 , 11 @entity1 and three @entity1 , underwent a total of 27 endoscopies, with 23 balloon dilations. Their average age was 46 years (range 33 - 59 years), average preoperative BMI was 47 kg/m 2, and they presented an average of 2.7 months after surgery (range 0.3 - 15.7 months). Of the 14 @entity1 , 13 had a stricture of the gastrojejunostomy and one @entity1 had @entity4 . For initial dilation, a 15 mm hydrostatic balloon was used in 12 @entity1 and an 18 mm balloon in two @entity1 . There was response to treatment with the 15 mm balloon in seven of the 12 @entity1 (58 %), and they required no further dilation; in one there was a response to a further 15 mm @entity384 ; in three @entity1 a response to subsequent 18 mm @entity384 ; and one @entity1 required 18 mm and 25 mm balloon dilations. The two @entity1 treated with an initial 18 mm @entity384 required no further dilations. The average length of follow-up after successful dilation was 18 months (range 7 - 30 months). There were no complications with any of the 23 dilations performed. CONCLUSION: Stenosis of the gastroenterostomy after laparoscopic gastric bypass occurred in 3.1 % of the @entity1 in this series. It can be successfully and safely treated with @entity384 with good long-term follow-up.
