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Management of Bariatric Complications Using Endoscopic Stents: a Multi-Center Study

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Abstract

Background

Complications after bariatric procedures including leaks and strictures can be difficult to treat. Endoscopic treatment may be preferable due to its less invasiveness. The aim of this study is to describe usage of stents in treating complications after bariatric procedures, along with its indications, methods, and outcome.

Material and Methods

A total of 87 patients underwent endoscopic stenting after a bariatric procedure from January 1, 2013, and December 31, 2016, in four bariatric centers. Previous bariatric procedures included Roux-en-Y gastric bypass (RYGB) (n = 33), sleeve gastrectomy (n = 50), duodenal switch (DS, n = 2), and vertical banded gastroplasty (VBG, n = 2).

Results

Mean age at intervention was 42.6 ± 10.0 years old, and mean body mass index was 41.6 ± 4.0 kg/m2 at the time of bariatric procedure. Reasons for stenting included sleeve leakage (n = 48), gatrojejunostomy (GJ) leakage (n = 21), stricture (n = 8), staple-line disruption (n = 7), and obstruction at the site of ring (n = 2). Migration occurred in 19.5% (n = 17) of patients undergoing stent placement and required repositioning or replacement of stents. Stenosis occurred in 13.8% of patients, which required endoscopic dilatation after stent removal.

Conclusion

Stents may be useful and effective in managing complications after different bariatric procedures, including RYGB and LSG.

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Authors and Affiliations

  1. Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando Health, 89 Copeland Dr, 1st Floor, Orlando, FL, USA

    Rena C. Moon, Andre F. Teixeira & Muhammad A. Jawad

  2. Department of Surgery, Universidade Federal de Pernambuco, Recife, Brazil

    Lyz Bezerra, Helga Cristina Almeida Wahnon Alhinho & Josemberg Campos

  3. Department of Bariatric Endoscopy, Kaiser Day Hospital, Sao Jose do Rio, Brazil

    Luiz Gustavo de Quadros

  4. Hospital 9 July, Sao Paulo, Brazil

    Artagnan Menezes Barbosa de Amorim & Manoel Galvao Neto

Authors
  1. Rena C. Moon
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  2. Andre F. Teixeira
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  3. Lyz Bezerra
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  4. Helga Cristina Almeida Wahnon Alhinho
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  5. Josemberg Campos
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  6. Luiz Gustavo de Quadros
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  7. Artagnan Menezes Barbosa de Amorim
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  8. Manoel Galvao Neto
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  9. Muhammad A. Jawad
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Corresponding author

Correspondence to Andre F. Teixeira.

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Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study, formal consent is not required.

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Does not apply.

Additional information

The abstract of this article has been selected to present at the International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) 2017 Annual Meeting (August 29–September 2, 2017, London, UK)

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Moon, R.C., Teixeira, A.F., Bezerra, L. et al. Management of Bariatric Complications Using Endoscopic Stents: a Multi-Center Study. OBES SURG 28, 4034–4038 (2018). https://doi.org/10.1007/s11695-018-3467-6

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  • DOI: https://doi.org/10.1007/s11695-018-3467-6

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