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Endoscopic Management of Vertical Banded Gastroplasty Stricture: Feasibility, Safety, and Efficacy

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Abstract

Background

Although vertical banded gastroplasty (VBG) is no longer performed in the USA, due to its popularity in 1980s, many patients still possess this anatomy with its inherent complications. The stomal stenosis secondary to tight ring or mesh is traditionally treated with surgical removal of the silastic ring or a complex revision, which was hampered by complications, technical complexity, and invasiveness. We described our experience of endoscopic management of this complex problem and the early outcomes.

Design

Retrospective study.

Setting

Tertiary care center.

Patients

Thirteen consecutive patients with gastric outlet obstruction who underwent endoscopic intervention after vertical banded gastroplasty (VBG).

Intervention

Endoscopic removal of silastic ring with self-expanding metal stent or endoscopic guided trans-gastric stapled stricturoplasty (TSS).

Main Outcome Measurements

Feasibility, safety, and efficacy of endoscopic approaches.

Results

Technical and clinical success in 11 patients (85 %) on first endoscopic attempt. Stent migrated in one patient, and another patient required second endoscopic intervention for recurring symptoms.

Limitations

Retrospective analysis, single-institution study, and small sample size.

Conclusion

Endoscopic approach to gastric outlet obstruction secondary to VBG regardless of type of restrictive device is safe and feasible with possible short-term benefit. This technique may also be use as bridge toward future revision surgery.

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Author information

Authors and Affiliations

  1. Division of Minimally Invasive Gastrointestinal Surgery, Department of Surgery, University of Minnesota Medical Center, 516 Delaware St SE, 11-164 Phillips-Wangensteen Building, Minneapolis, MN, 55455, USA

    Chin Hong Lim, Sayeed Ikramuddin & Daniel B. Leslie

  2. Division of Gastroenterology and Hepatology, Department of Medicine, University of Minnesota Medical Center, Minneapolis, MN, USA

    Stuart K. Amateau

Authors
  1. Chin Hong Lim
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  2. Stuart K. Amateau
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  3. Sayeed Ikramuddin
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  4. Daniel B. Leslie
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Corresponding author

Correspondence to Chin Hong Lim.

Ethics declarations

This study was approved by the respective institutional review board of our center.

Conflict of Interest

The authors declare that they have no conflict of interests.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

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Lim, C.H., Amateau, S.K., Ikramuddin, S. et al. Endoscopic Management of Vertical Banded Gastroplasty Stricture: Feasibility, Safety, and Efficacy. OBES SURG 26, 2802–2808 (2016). https://doi.org/10.1007/s11695-016-2357-z

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  • DOI: https://doi.org/10.1007/s11695-016-2357-z

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