Introduction: Gastrojejunostomy stenosis after Roux-en-Y gastric bypass (RYGB) can usually be treated with endoscopic methods. This study tested the hypotheses that surgeon performed endoscopic balloon dilation for gastrojejuntostomy stenosis is effective and safe.
Methods: All patients who underwent endoscopic balloon dilation for a gastrojejunstomy stenosis by two surgeons were included in this study. All patients underwent similar techniques of endoscopic balloon dilation. Wire guided balloon dilation was performed in each case where the endoscope could not be passed into the jejunum. Charts were reviewed for success and complications.Results. There were 32 endoscopic balloon dilations in 20 patients. Stenosis occurred an average of 2.4 years (Range: 1 month to 20.5 years) after the original RYGB. Patients required an average of 1.7 dilations (Range: 1 to 10 dilations) for success; although 75% of patients only required 1 dilation. There was 1 (3%) microperforation (pneumoperitenum with no evidence of radiographic dye leak) after one of the dilations in the patient who received 10 total dilations. The patient was observed with no further sequelae from her dilation. No other complications were noted. After the last dilation, all patients had resolution/improvement of their symptoms.
Conclusions: Surgeon performed endoscopic balloon dilation is effective and safe. Multiple dilations can be performed in patients who have recurrent stenosis. Patients who have multiple dilations may be at a higher risk of complications.