| Peroral endoscopic anastomotic reduction improves intractable dumping syndrome in Roux-en-Y gastric bypass patients. | |
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MedLine Citation:
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PMID: 19560979 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Dumping syndrome is a well-described consequence of Roux-en-Y gastric bypass. Although the condition can benefit some patients with morbid obesity, a subset will develop intractable dumping syndrome characterized by symptomatic episodes with most meals. We describe the first series of patients successfully treated endoscopically for intractable dumping syndrome. METHODS: Endoscopic gastrojejunal anastomotic reduction was performed in patients with intractable dumping syndrome after Roux-en-Y gastric bypass using a combination of argon plasma coagulation, endoscopic suturing, and fibrin glue. The technical feasibility of endoscopic anastomotic reduction and the clinical improvement in dumping symptoms were assessed by clinical follow-up. RESULTS: Endoscopic anastomotic reduction was technically successful in 6 consecutive patients with a dilated gastrojejunal anastomosis and intractable dumping syndrome. One patient reported hematemesis 2 days after the procedure that was treated endoscopically. No other significant complications occurred. Complete and persistent resolution of the dumping symptoms was achieved in all patients, with a median follow-up of 636 days. CONCLUSION: Endoscopic anastomotic reduction appears technically feasible and safe and might be a minimally invasive treatment option for patients who experience intractable dumping symptoms after Roux-en-Y gastric bypass. Additional studies are needed to determine the long-term efficacy of this procedure. |
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Authors:
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Gloria Fern?ndez-Esparrach; David B Lautz; Christopher C Thompson |
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Publication Detail:
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Type: Journal Article Date: 2009-04-23 |
Journal Detail:
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Title: Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery Volume: 6 ISSN: 1878-7533 ISO Abbreviation: Surg Obes Relat Dis Publication Date: 2010 Jan-Feb |
Date Detail:
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Created Date: 2010-02-04 Completed Date: 2010-06-01 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101233161 Medline TA: Surg Obes Relat Dis Country: United States |
Other Details:
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Languages: eng Pagination: 36-40 Citation Subset: IM |
Copyright Information:
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2010 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved. |
Affiliation:
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Department of Medicine, Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts 02115, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Anastomosis, Surgical Dumping Syndrome / etiology, physiopathology, surgery* Endoscopy, Gastrointestinal* Gastric Bypass / adverse effects* Gastric Emptying / physiology Humans Jejunum / physiopathology, surgery Stomach / physiopathology, surgery Suture Techniques |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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