Treatment of ring slippage after gastric bypass: long-term results after endoscopic dilation with an achalasia balloon (with videos)

Campos, Josemberg Marins; Evangelista, Luis Fernando; Ferraz, A.; Neto, Manoel Galvao; Moura, Eduardo Guimarães Hourneaux de; Sakai, Paulo; Ferraz, Edmundo Machado

doi:10.1016/j.gie.2010.01.057

Cited by 25 publications

(13 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Since the introduction of TTS endoscopy, endoscopic balloon dilation of postoperative stricture has become generally accepted as an effective and safe therapeutic tool. Details of endoscopic balloon dilation procedures and clinical outcomes are summarized in Table 4 [ 44 - 47 , 49 - 51 , 53 - 56 ]. Most of the significant strictures are found during the first 3 months after surgery, and a proportion of patients require repeat dilation, ranging from 2 to 4 sessions and even up to 7 sessions.…”

Section: Stricturementioning

confidence: 99%

Endoscopic Approach for Major Complications of Bariatric Surgery

Joo

2017

Clin Endosc

View full text Add to dashboard Cite

As lifestyle and diet patterns have become westernized in East Asia, the prevalence of obesity has rapidly increased. Bariatric surgeries, such as Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and laparoscopic adjustable gastric banding (LAGB), are considered the first-line treatment option in patients with severe obesity. However, postoperative complications have increased and the proper management of these complications, including the use of endoscopic procedures, has become important. The most serious complications, such as leaks and fistulas, can be treated with endoscopic stent placement and injection of fibrin glue, and a novel full-thickness closure over-the-scope clip (OTSC) has been used for treatment of postoperative leaks. Stricture at the gastrojejunal (GJ) anastomosis site after RYGB or incisura angularis in SG can be managed using stents or endoscopic balloon dilation. Dilation of the GJ anastomosis or gastric pouch may lead to failure of weight loss, and the use of endoscopic sclerotherapy, novel endoscopic suturing devices, and OTSCs have been attempted. Intragastric migration of the gastric band can be successfully treated using various endoscopic tools. Endoscopy plays a pivotal role in the management of post-bariatric complications, and close cooperation between endoscopists and bariatric surgeons may further increase the success rate of endoscopic procedures.

show abstract

Section: Stricturementioning

confidence: 99%

Endoscopic Approach for Major Complications of Bariatric Surgery

Joo

2017

Clin Endosc

View full text Add to dashboard Cite

show abstract

“…Four types of internal hernia were seen following gastric bypass; Mesenteric, and mesojejunal, Petersons and jejuno-jejunal herniae are identified [46,47], (L2+), [48], (L2++). Obstruction could be due to a mechanical problem or technical error at the anastomosis or from banded gastric bypass operation [49], (L3). G-J stricture was another cause of obstruction and the incidence could reach 27% [50], (L2++).…”

Section: Resultsmentioning

confidence: 99%

Bariatric emergencies: current evidence and strategies of management

Hussain

El-Hasani

2013

World J Emerg Surg

View full text Add to dashboard Cite

BackgroundThe demand for bariatric surgery is increasing and the postoperative complications are seen more frequently. The aim of this paper is to review the current outcomes of bariatric surgery emergencies and to formulate a pathway of safe management.MethodsThe PubMed and Google search for English literatures relevant to emergencies of bariatric surgery was made, 6358 articles were found and 90 papers were selected based on relevance, power of the study, recent papers and laparoscopic workload. The pooled data was collected from these articles that were addressing the complications and emergency treatment of bariatric patients. 830,998 patients were included in this review.ResultsBariatric emergencies were increasingly seen in the Accident and Emergency departments, the serious outcomes were reported following complex operations like gastric bypass but also after gastric band and the causes were technical errors, suboptimal evaluation, failure of effective communication with bariatric teams who performed the initial operation, patients factors, and delay in the presentation. The mortality ranged from 0.14%-2.2% and increased for revisional surgery to 6.5% (p = 0.002). Inspite of this, mortality following bariatric surgery is still less than that of control group of obese patients (p = value 0.01).ConclusionsMost mortality and catastrophic outcomes following bariatric surgery are preventable. The awareness of bariatric emergencies and its effective management are the gold standards for best outcomes. An algorithm is suggested and needs further evaluation.

show abstract

“…However, serious complications, including perforation, have been reported [ 1 ]. Campos et al [ 9 ] showed that gastric pouch outlet stenosis due to silastic ring slippage after RYGB was successfully managed with preliminary dilation using a dilator (Cook Biotech Inc.) or a CRE balloon dilated up to 20 mm, followed by definitive dilation using a 30-mm achalasia balloon.…”

Section: Discussionmentioning

confidence: 99%

“…In our case, the follow-up was taken care of by phone. Based on the experience of Campos et al [ 9 ], a follow up is necessary. They reported that a successful removal of the band was achieved in all patients, but nine patients (22%) required additional endoscopic balloon dilation after removal of the stent.…”

Section: Discussionmentioning

confidence: 99%

A nutrition problem solved by a two-step endoscopic removal of a non-adjustable gastric band

Johansen

Norum

Engebretsen

et al. 2018

Journal of Surgical Case Reports

View full text Add to dashboard Cite

Bariatric surgery is an effective approach for weight loss and short-term improvement in metabolic disorders. Stenosis is a common complication of gastric banding. Balloon dilatation or gastrotomy has been employed in this setting. Few studies have indicated endoscopic removal of the band a feasible procedure. We present a 60-year-old female who underwent gastric banding in 1985 and suffered from late stenosis and malnutrition. Endoscopy revealed a severe stenosis. A two-step procedure was performed. Initially a coated stent was placed into the stenosis to achieve pressure necrosis. Two weeks later, the stent was removed and the band was removed endoscopically. The procedure was performed without any complications. The patient was discharged the next day. A follow-up after 2 months revealed no problems with stenosis or malnutrition. The procedure was a safe, efficient and convenient way of handling late stenosis after gastric banding.

show abstract

Treatment of ring slippage after gastric bypass: long-term results after endoscopic dilation with an achalasia balloon (with videos)

Cited by 25 publications

References 9 publications

Endoscopic Approach for Major Complications of Bariatric Surgery

Endoscopic Approach for Major Complications of Bariatric Surgery

Bariatric emergencies: current evidence and strategies of management

A nutrition problem solved by a two-step endoscopic removal of a non-adjustable gastric band

Contact Info

Product

Resources

About