Copyright ©2012 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastrointest Endosc. Jul 16, 2012; 4(7): 290-295
Published online Jul 16, 2012. doi: 10.4253/wjge.v4.i7.290
Stenosis in gastric bypass: Endoscopic management
Jesús Espinel, Eugenia Pinedo
Jesús Espinel, Endoscopy Unit, Gastroenterology Department, Hospital de León, 24071 León, Spain
Eugenia Pinedo, Radiology Department, Hospital de León, 24071 León, Spain
Author contributions: Both authors contribute equally to the paper.
Correspondence to: Jesús Espinel, MD, Endoscopy Unit, Gastroenterology Department, Hospital de León, 24071 León, Spain. espinel.jesus@gmail.com
Telephone: +34-987-237400 Fax: +34-987-235318
Received: May 20, 2011
Revised: May 2, 2012
Accepted: July 1, 2012
Published online: July 16, 2012

Gastric bypass is a treatment option for morbid obesity. Stenosis of the gastrojejunal anastomosis is a recognized complication. The pathophysiological mechanisms involved in the formation of stenosis are not well known. Gastrojejunal strictures can be classified based on time of onset, mechanism of formation, and endoscopic aspect. Diagnosis is usually obtained by endoscopy. The two main treatment alternatives for stomal stricture are: endoscopic dilatation (balloon or bouginage) and surgical revision (open or laparoscopic). Both techniques of dilation [through-the-scope (TTS) balloon dilators, Bougienage dilators] are considered safe, effective, and do not require hospitalization. The optimal technique for dilation of stomal strictures remains to be determined, but many authors prefer the use of TTS balloon catheters. Most patients can be successfully treated with 1 or 2 sessions. The need for reconstructive surgery of a stomal stricture is extremely rare.

Keywords: Gastric bypass, Gastrojejunal anastomosis, Balloon dilation, Stricture, Endoscopic dilation, Bougienage dilation, Stenosis of the anastomosis, Obesity