Abstract

LEYBA, José Luis et al. Estenosis gastroyeyunal en el bypass gástrico por laparoscopia. Gac Méd Caracas [online]. 2006, vol.114, n.2, pp.113-117. ISSN 0367-4762.

Gastrojejunal stricture after laparoscopic gastric bypass is a complication reported with all techniques of anastomosis described. In the present study we reviewed the rate of gastrojejunal stricture of 42 patients following laparoscopic gastric bypass by morbid obesity, using a 21 mm circular stapler for such anastomosis. We also evaluated the symptoms, diagnosis, and treatment of this complication, comparing as well the excess body weight loss after dilation, with that of patients without stricture. Ten patients (23,8 %) had gastrojejunal stricture, characterized by nausea, vomiting and impossibility to progress food intake up to a complete diet. The symptoms were presented between the 4^th and 8^th postoperative week and the upper endoscopy was diagnostic in 100 % of the cases. The treatment consisted in endoscopic dilation of the stricture with complete resolution of the clinical symptoms in all the patients. One patient presented a microperforation of the anastomosis following the dilation, treating this with a non operative management. The excess body weight loss one year after surgery didn’t presented significant differences between both groups of patients. We concluded that gastrojejunal stricture after 21 mm circular stapler anastomosis is a frequent complication whose diagnosis and treatment must be done by upper endoscopy. The study of other techniques of laparoscopic gastrojejunostomy is necessary with the aim to reduce these rates maintaining the safety and effectiveness of the procedure.

Keywords : Gastric bypass; Laparoscopy; Gastrojejunal stricture; Endoscopy.