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Obesity Surgery

, Volume 19, Issue 12, pp 1631–1635 | Cite as

Gastrojejunal Anastomotic Stenosis in Laparoscopic Gastric Bypass with a Circular Stapler (21 mm): Incidence, Treatment and Long-term Follow-up

  • Maria Dolores FrutosEmail author
  • Juan Luján
  • Arancha García
  • Quiteria Hernández
  • Graciela Valero
  • José Gil
  • Pascual Parrilla
Clinical Research

Abstract

Background

One of the keys to the long-term success of laparoscopic gastric bypass (LGBP) is performing a small-diameter gastrojejunal anastomosis, which occasionally involves an increased incidence of stenosis.

Methods

Between May 2000 and October 2008, 676 patients underwent LGBP with a no. 21 circular stapler to create the gastrojejunoanastomosis (GJA). We define stenosis when clinical symptoms suggest an obstruction and it is impossible to pass a 10-mm endoscope through the GJA. The treatment of patients with stenosis was endoscopic dilation with 10–15-mm balloons.

Results

A total of 23 patients (3.4%) developed stenosis of whom 20 were females (3%) and three males (0.4%) with a mean age of 40.7 ± 11.6 years (range, 16–71 years) and a body mass index of 48.1 ± 6.9 kg/m2 (range, 34–78 kg/m2). The time between surgery and the onset of symptoms was 46.8 ± 24.5 days (range, 15–93 days). The stricture was resolved in all patients with endoscopic dilation: 18 patients with one dilation, three patients with two dilations and two patients with three dilations. There were no complications.

Conclusions

The incidence of gastrojejunal anastomotic stenosis in LGBP performed with a 21-mm circular stapler is low, and endoscopic dilation is an effective and complication-free treatment in 100% of cases.

Keywords

Bariatric Surgery Obstructive Sleep Apnoea Gastric Pouch Circular Stapler Laparoscopic Gastric Bypass 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Springer Science + Business Media, LLC 2009

Authors and Affiliations

  • Maria Dolores Frutos
    • 1
    • 2
    Email author
  • Juan Luján
    • 1
  • Arancha García
    • 1
  • Quiteria Hernández
    • 1
  • Graciela Valero
    • 1
  • José Gil
    • 1
  • Pascual Parrilla
    • 1
  1. 1.Departamento de Cirugía GeneralHospital Universitario “Virgen de la Arrixaca”MurciaSpain
  2. 2.Servicio de Cirugía GeneralHospital Universitario “Virgen de la Arrixaca”MurciaSpain

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