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World J Gastrointest Endosc. Sep 16, 2016; 8(17): 591-599
Published online Sep 16, 2016. doi: 10.4253/wjge.v8.i17.591
Endoscopic management of post-bariatric surgery complications
Mena Boules, Julietta Chang, Ivy N Haskins, Gautam Sharma, Dvir Froylich, Kevin El-Hayek, John Rodriguez, Matthew Kroh
Mena Boules, Julietta Chang, Ivy N Haskins, Gautam Sharma, Dvir Froylich, Kevin El-Hayek, John Rodriguez, Matthew Kroh, Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, Cleveland, OH 44195, United States
Author contributions: Boules M contributed to writing of the manuscript, literature review, incorporating revisions, and final review; Chang J contributed to writing of the manuscript and literature review; Haskins IN contributed to writing of the manuscript, literature review, and incorporating revisions; Sharma G contributed to literature review; Froylich D contributed to literature review and revisions; El-Hayek K contributed to writing of the manuscript, final review; Rodriguez J contributed to writing of the manuscript and revision review; Kroh M contributed to writing of the manuscript, revisions review, study concept, and final review of the manuscript.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors on this manuscript. All authors approve the final version of this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Matthew Kroh, MD, Director of Surgical Endoscopy, Associate Professor of Surgery Cleveland Clinic Lerner College of Medicine, Department of General Surgery, Digestive Disease Institute, Cleveland Clinic, 9500 Euclid Avenue, A100, Cleveland, OH 44195, United States. krohm@ccf.org
Telephone: +1-216-4446664 Fax: +1-216-4442153
Received: April 29, 2016
Peer-review started: May 3, 2016
First decision: June 17, 2016
Revised: July 2, 2016
Accepted: July 20, 2016
Article in press: July 22, 2016
Published online: September 16, 2016
Abstract

Understanding the technical constructs of bariatric surgery is important to the treating endoscopist to maximize effective endoluminal therapy. Post-operative complication rates vary widely based on the complication of interest, and have been reported to be as high as 68% following adjustable gastric banding. Similarly, there is a wide range of presenting symptoms for post-operative bariatric complications, including abdominal pain, nausea and vomiting, dysphagia, gastrointestinal hemorrhage, and weight regain, all of which may provoke an endoscopic assessment. Bleeding and anastomotic leak are considered to be early (< 30 d) complications, whereas strictures, marginal ulcers, band erosions, and weight loss failure or weight recidivism are typically considered late (> 30 d) complications. Treatment of complications in the immediate post-operative period may require unique considerations. Endoluminal therapies serve as adjuncts to surgical and radiographic procedures. This review aims to summarize the spectrum and efficacy of endoscopic management of post-operative bariatric complications.

Keywords: Bariatric surgery, Weight loss surgery, Bariatric complications, Endoscopy, Bariatrics

Core tip: There are minimal reviews in the literature discussing therapeutic options for endoscopic management of bariatric surgery complications. Treatment of bariatric complications in the post-operative period may require unique considerations. Endoluminal therapies serve as adjuncts to surgical and radiographic procedures. This review aims to summarize the spectrum and efficacy of endoscopic management of post-operative bariatric complications.