Stenosis after sleeve gastrectomy – cause, diagnosis and management strategy

Binda, Artur; Jaworski, Paweł; Tarnowski, Wiesław

doi:10.2478/pjs-2013-0112

Cited by 13 publications

(13 citation statements)

References 22 publications

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“…70,73,[75][76][77] Strictures Stricture of the sleeve is a rare complication, reported to occur in up to 3.9% of patients. 78 Focal sleeve narrowing can occur early post-operatively due to edema or ischemia, but fixed narrowing is more commonly seen in the late post-operative course due to Figure 17. Expected appearance following SG on UGI.…”

Section: Sg Complications Leakmentioning

confidence: 99%

“…As with other restrictive procedures, failed weight loss may also be a consequence of pouch dilatation. [78][79][80][81] UGI is more effective than CT to detect stricture, and will reveal significant narrowing of the sleeve lumen with delayed or no passage of contrast. In addition, the proximal gastric pouch may be dilated (Figure 22).…”

Section: Sg Complications Leakmentioning

confidence: 99%

“…When conservative measures fail, definitive treatment often requires surgical conversion to RYGB. [78][79][80][82][83][84] Additional reported complications following SG include gastric motility problems, bleeding, infection and splenic infarction/ ischemia. 62,82,85 Splenic infarction occurs due to compromise of vascular supply to the spleen after ligation of short gastric arteries.…”

Section: Sg Complications Leakmentioning

confidence: 99%

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Imaging following bariatric surgery: roux-en-Y gastric bypass, laparoscopic adjustable gastric banding and sleeve gastrectomy

Clayton

Carucci

2018

BJR

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Morbid obesity is an increasing health problem, and bariatric surgery is a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical post-operative findings of the Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB) and sleeve gastrectomy (SG) procedures on upper gastrointestinal (UGI) series and computerized tomography (CT) are presented. An overview of the potential complications is provided in addition to a description of potential pitfalls in interpreting these studies.

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Section: Sg Complications Leakmentioning

confidence: 99%

Section: Sg Complications Leakmentioning

confidence: 99%

Section: Sg Complications Leakmentioning

confidence: 99%

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Imaging following bariatric surgery: roux-en-Y gastric bypass, laparoscopic adjustable gastric banding and sleeve gastrectomy

Clayton

Carucci

2018

BJR

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“…Suggested management of subacute or chronic gastric sleeve stenosis has included therapeutic endoscopic intervention and surgical procedures[13,14,38,40,50]. Therapeutic endoscopic interventions include hydrostatic balloon dilatation with a repeat session as needed at 4 to 6 wk[49,51,52] or use of a pneumatic achalasia balloon dilator. Parikh et al[53] identified “short-segment” gastric sleeve stenosis in 8 patients out of 230 patients who underwent VSG, and endoscopic balloon dilatation successfully resolved symptoms in all 8 patients with a mean of 1.6 dilatations.…”

Section: Discussionmentioning

confidence: 99%

Dysphagia after vertical sleeve gastrectomy: Evaluation of risk factors and assessment of endoscopic intervention

Nath¹,

Yewale²,

Tran³

et al. 2016

WJG

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AIMTo evaluate the risks of medical conditions, evaluate gastric sleeve narrowing, and assess hydrostatic balloon dilatation to treat dysphagia after vertical sleeve gastrectomy (VSG).METHODSVSG is being performed more frequently worldwide as a treatment for medically-complicated obesity, and dysphagia is common post-operatively. We hypothesize that post-operative dysphagia is related to underlying medical conditions or narrowing of the gastric sleeve. This is a retrospective, single institution study of consecutive patients who underwent sleeve gastrectomy from 2013 to 2015. Patients with previous bariatric procedures were excluded. Narrowing of a gastric sleeve includes: inability to pass a 9.6 mm gastroscope due to stenosis or sharp angulation or spiral hindering its passage.RESULTSOf 400 consecutive patients, 352 are included; the prevalence of dysphagia is 22.7%; 33 patients (9.3%) have narrowing of the sleeve with 25 (7.1%) having sharp angulation or a spiral while 8 (2.3%) have a stenosis. All 33 patients underwent balloon dilatation of the gastric sleeve and dysphagia resolved in 13 patients (39%); 10 patients (30%) noted resolution of dysphagia after two additional dilatations. In a multivariate model, medical conditions associated with post-operative dysphagia include diabetes mellitus, symptoms of esophageal reflux, a low whole blood thiamine level, hypothyroidism, use of non-steroidal anti-inflammatory drugs, and use of opioids.CONCLUSIONNarrowing of the gastric sleeve and gastric sleeve stenosis are common after VSG. Endoscopic balloon dilatations of the gastric sleeve resolves dysphagia in 69% of patients.

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“…Postoperative gastric stenosis (GS) is a well-recognized complication of bariatric surgery. The incidence of symptomatic stenosis in LSG is thought to be underreported and may actually approach 4% [86] while the incidence of GS at the GJ anastomosis site in RYGB is reported as high as 7.8% [21]. Postoperative GS can be described as either functional or organic.…”

Section: Stenosismentioning

confidence: 99%

Endoscopic therapeutic interventions for management of postoperative bariatric surgery complications

Westerveld

Sharaiha

2020

Techniques and Innovations in Gastrointestinal Endoscopy

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Stenosis after sleeve gastrectomy – cause, diagnosis and management strategy

Cited by 13 publications

References 22 publications

Imaging following bariatric surgery: roux-en-Y gastric bypass, laparoscopic adjustable gastric banding and sleeve gastrectomy

Imaging following bariatric surgery: roux-en-Y gastric bypass, laparoscopic adjustable gastric banding and sleeve gastrectomy

Dysphagia after vertical sleeve gastrectomy: Evaluation of risk factors and assessment of endoscopic intervention

Endoscopic therapeutic interventions for management of postoperative bariatric surgery complications

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