The role of endoscopic stents in the management of chronic anastomotic and staple line leaks and chronic strictures after bariatric surgery

Presentation and surgical management of leaks after mini–gastric bypass for morbid obesity

“…However UGI series are reported to have a low sensitivity because they detect a leak only in the 20% of patients [33,34]. In our series UGI [27,35,40,41]. In our limited experience endoluminal stenting for post-MGB leakage does not seem to be recommended because of the risk of migration into the gastro-jejunostomy that could lead to obstruction or perforation.…”

Endoluminal solutions to bariatric surgery complications: A review with a focus on technical aspects and results

“…Esophageal FCSEMS have also been used to treat chronic gastrojejunostomy strictures with a 12.5% successful response[51]. In this study, all of the patients had a stricture at the gastrojejunal anastomosis after RYGB but one had a stricture at the duodeno-ileal anastomosis following BPD/DS.…”

“…Endoscopically placed self-expandable endoscopic stents (SEES) offer several advantages. They decrease the intraluminal pressure, which is one of the pathophysiologic factors of leaks after SG, prevent or decrease peritoneal contamination by excluding the wall defect from esophagogastric secretions and thus, promote healing of the leak and permit oral nutrition to be resumed[51,97]. This is the endoscopic treatment for leaks after bariatric surgery where most evidence is available.…”

Endoscopic management of bariatric surgical complications

“…Puig et al [25] reported a 12.5% response rate in 16 patients with chronic anastomotic strictures treated with FCSEMS. Poor outcomes may be related to the high rate of stent migration (47%), although this can likely now be reduced with endoluminal anchoring techniques such as the endoscopic suturing or over-the-scope clips (OTSC).…”