Long-term outcome after endoscopic stent therapy for complications after bariatric surgery

Excerpt

Although bariatric surgery effectively reduces the mortality risk from obesity-related comorbidities [1, 2], it is associated with a 1–5% risk of anastomotic complications. Anastomotic leaks have traditionally been treated with a combination of drainage with long-term parenteral nutrition or postanastomotic enteral nutrition, allowing the leak to heal. Strictures at the gastrojejunostomy are initially treated with repeated endoscopic dilation, but revisional bariatric surgery is needed for refractory strictures with its associated high complication rate. Chronic fistulas are initially treated conservatively but often need high-risk revisional surgery. Recently, endoscopic covered stents have been used successfully for treatment of anastomotic complications after esophageal resection [3‐5]. Case series evaluating stents to treat anastomotic leaks after Roux-en-Y gastric bypass have shown success [6‐9]. However, the numbers of patients enrolled in these studies are small, and only short-term outcomes are reported. …