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Postoperative Strictures

  • Mandi Joshi
  • Emanuele Lo Menzo
  • Samuel Szomstein
  • Raul J. Rosenthal
Chapter

Abstract

Bariatric surgery has been recognized as the most effective and durable treatment for morbid obesity and its complications. With the increase in popularity of such procedures, the number of possible complications has been increasing as well. Among the complications, intake intolerance and strictures are source of significant morbidity and readmission after bariatric surgery. The incidence and etiology of strictures vary significantly based on the bariatric procedure performed. Strictures and oral intolerance after Roux-en-Y gastric bypass (RYGB) have been described in up to 30% of the patients. The etiology is multifactorial, and the treatment is tailored to the etiology. Commonly, the strictures can be resolved with nonsurgical interventions; however, surgical revisions are sometime warranted. Laparoscopic sleeve gastrectomy (LSG) has gained popularity over the years, and it is now the most commonly performed bariatric procedure worldwide. The reason for its popularity resides in its technical simplicity and paucity of postoperative complications. However, several key technical aspects are important to remember in order to avoid significantly morbid complications. Stricture after sleeve gastrectomies has been reported up to 4% the case. Although some of the causes are unavoidable, specific technical maneuvers are important to decrease the incidence of strictures. In this chapter we analyze the potential contributing factors to the development of strictures after LSG. We also identify the treatment options available to deal with such complications.

Keywords

Gastric bypass Sleeve gastrectomy Stricture Marginal ulcer Oral intolerance 

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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Mandi Joshi
    • 1
  • Emanuele Lo Menzo
    • 2
  • Samuel Szomstein
    • 2
  • Raul J. Rosenthal
    • 3
  1. 1.Department of SurgeryDaVita Medical GroupAlbuquerqueUSA
  2. 2.The Bariatric and Metabolic InstituteCleveland Clinic Florida – WestonWestonUSA
  3. 3.Department of SurgeryCleveland Clinic FloridaWestonUSA

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