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Obesity Surgery
Published in: Obesity Surgery 5/2017

01-05-2017 | Original Contributions

Feasibility and Importance of Enteroscopy after Gastric Bypass

Authors: Dean Keren, H. Madi, I. Matter, A. Assalia, T. Rainis

Published in: Obesity Surgery | Issue 5/2017

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Abstract

Background

Bariatric surgery has increased in popularity, with Roux-en-Y Gastric Bypass (RYGB) being one of the most frequently performed. This leads to many cases in which the stomach is removed from routine gastroscopy access, sometimes being a major source of concern. Performing enteroscopy in these patients is technically difficult. We present our experience with 24 cases in which the aim was to access the detached stomach.

Methods

Retrospective analysis on RYGB enteroscopy procedures aimed to access the detached stomach. Data recorded: demographic parameters, indication, gas insufflation, time to bypass stomach, total procedure and recovery times, and endoscopic and pathological findings.

Results

This study included 24 patients who underwent RYGB in the previous 3–36 months. Indications were chronic abdominal pain, refractory anemia, or unexplainable weight loss. Detached stomach was accessed in 79% of patients. Access time ranged from 25 to 55 min. Recovery time for all procedures was 86.66 min on average and shorter with CO2 insufflation (42.5 min). All detached stomachs showed macroscopic gastritis; four of them were Helicobacter pylori positive. Significant findings included three patients with jejunojejunostomy stenosis and one patient with a marginal gastrojejunal ulcer, which was later diagnosed with Signet ring cell carcinoma of the proximal anastomosis.

Conclusions

We present the feasibility and importance of enteroscopy of the detached stomach and believe that this procedure should be performed more frequently. A high index of suspicion is needed for postoperative symptoms in order to exclude significant pathologies and reassure symptomatic patients that there is no abnormality in the bypassed stomach.
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Metadata
Title
Feasibility and Importance of Enteroscopy after Gastric Bypass
Authors
Dean Keren
H. Madi
I. Matter
A. Assalia
T. Rainis
Publication date
01-05-2017
Publisher
Springer US
Published in
Obesity Surgery / Issue 5/2017
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-016-2472-x

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