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Obesity Surgery

, Volume 26, Issue 5, pp 995–1001 | Cite as

Gastric Stenosis After Laparoscopic Sleeve Gastrectomy: Diagnosis and Management

  • Lionel Rebibo
  • Sami Hakim
  • Abdennaceur Dhahri
  • Thierry Yzet
  • Richard Delcenserie
  • Jean-Marc RegimbeauEmail author
Original Contributions

Abstract

Purpose

The use of laparoscopic sleeve gastrectomy (LSG) is increasing worldwide. Although post-LSG gastric stenosis (GS) is less frequent, it has not been well defined and lacks standardized management procedures. The objective of the present study was to describe a series of patients with GS symptoms after LSG and to develop a standardized management procedure for this complication.

Methods

We performed a retrospective analysis of a prospective database of patients presenting with GS after LSG procedures performed between January 2008 and March 2014. The primary efficacy criterion was the frequency of post-LSG GS. GS was classified as functional (i.e. a gastric twist) or organic. The secondary efficacy criteria included the time interval between LSG and diagnosis of GS, the type of stenosis, the type of management, and the follow-up data.

Results

During the study period, 1210 patients underwent primary or secondary LSG. Seventeen patients had post-operative symptoms of GS (1.4 %); one patient had achalasia that had not been diagnosed preoperatively and thus was excluded from our analysis. The median time interval between LSG and diagnosis of GS was 47.2 days (1–114). Eleven patients had organic GS and six had functional GS. Seven patients required nutritional support. Endoscopic treatment was successful in 15 patients (88.2 %) after balloon dilatation (n = 13) or insertion of a covered stent (n = 2). Two of the 15 patients required conversion to Roux-en-Y gastric bypass (11.8 %).

Conclusion

GS after LSG is a rare complication but requires standardized management. Most cases can be treated successfully with endoscopic balloon dilatation.

Keywords

Laparoscopic sleeve gastrectomy Stenosis Gastric twist Endoscopic dilatation Stent 

Abbreviations

BMI

body mass index

GF

gastric fistula

GS

gastric stenosis

LSG

laparoscopic sleeve gastrectomy

OSA

obstructive sleep apnea syndrome

Notes

Conflict of Interest

None of the authors have any conflicts of interest to declare.

Ethical Approval

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

Informed Consent

Informed consent for this study does not apply.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Lionel Rebibo
    • 1
  • Sami Hakim
    • 2
  • Abdennaceur Dhahri
    • 1
  • Thierry Yzet
    • 3
  • Richard Delcenserie
    • 2
  • Jean-Marc Regimbeau
    • 1
    • 4
    • 5
    Email author
  1. 1.Department of Digestive SurgeryAmiens University Medical CenterAmiens Cedex 01France
  2. 2.Department of GastroentrologyAmiens University Medical CenterAmiens Cedex 01France
  3. 3.Department of RadiologyAmiens University Medical CenterAmiens Cedex 01France
  4. 4.Jules Verne University of PicardieAmiens Cedex 01France
  5. 5.Clinical Research CenterAmiens University Medical CenterAmiens Cedex 01France

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