Anastomotic Stricture Formation after Roux-En-Y Gastric Bypass Surgery: A Single Center Retrospective Cohort Study

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dc.contributor.authorVanga, Rohini R.en
dc.contributor.authorMajithia, Rajen
dc.contributor.authorFinelli, Frederick C.en
dc.contributor.authorShope, Timothy R.en
dc.contributor.authorKoch, Timothy R.en
dc.date.accessioned2022-08-17T19:06:31Zen
dc.date.available2022-08-17T19:06:31Zen
dc.date.issued2013-12-21en
dc.date.updated2022-08-06T22:17:19Zen
dc.description.abstractAIM: Roux-en-Y gastric bypass is used for treating medically-complicated obesity. Gastrojejunal anastomotic stricture is a common complication reported in 3% to 27% of these patients. The pathogenesis of postoperative strictures is not well understood, but ischemia has been hypothesized as a major cause. The aim of this study was to evaluate potential factors that could increase the risk of a post-operative anastomotic stricture. METHODS: The records of 165 patients who had gastric bypass from June 2006 to March 2011 were reviewed. Demographics, co-morbidities, smoking status, surgical approach, medication use, and H. pylori status were noted, as well as a diagnosis of gastrojejunal stricture and/or marginal ulceration. RESULTS: Thirty-four symptomatic patients (21%) developed gastrojejunal stricture, while 26 patients (16%) developed marginal ulceration. The majority were women (89%) with a mean age of 43 years and mean body mass index of 51 kg/m2. Caucasians were at a higher risk for developing a stricture. Proton pump inhibitor use and marginal ulceration were significantly associated with risk of stricture, and there was a strong trend in patients with obstructive sleep apnea. Post-operative strictures were successfully treated with an average of two dilation sessions using an endoscopic through-the-scope balloon dilator. CONCLUSION: After gastric bypass, proton pump inhibitor use and marginal ulceration were associated with anastomotic stricture formation. Strictures were more common in Caucasians. A trend towards an increased risk of strictures in patients with sleep apnea was observed, supporting the role of ischemia. Endoscopic balloon dilation relieved symptoms in all patients.en
dc.description.versionPublished versionen
dc.format.mimetypeapplication/pdfen
dc.identifier.doihttps://doi.org/10.6051/j.issn.2224-3992.2013.02.383en
dc.identifier.orcidKoch, Timothy [0000-0002-8026-9653]en
dc.identifier.urihttp://hdl.handle.net/10919/111540en
dc.language.isoenen
dc.publisherACT Publishingen
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectObesityen
dc.subjectBariatric surgeryen
dc.subjectGastric bypass surgeryen
dc.subjectGastrojejunostomyen
dc.subjectAnastomotic strictureen
dc.subjectEndoscopyen
dc.titleAnastomotic Stricture Formation after Roux-En-Y Gastric Bypass Surgery: A Single Center Retrospective Cohort Studyen
dc.title.serialJournal of Gastroenterology and Hepatology Researchen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
dc.type.otherArticleen
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicineen
pubs.organisational-group/Virginia Tech/VT Carilion School of Medicine/Internal Medicine/General IMen

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