Management of Bariatric Complications Using Endoscopic Stents: a Multi-Center Study.

Abstract

Complications after bariatric procedures including leaks and strictures can be difficult to treat. Endoscopic treatment may be preferable due to its less invasiveness. The aim of this study is to describe usage of stents in treating complications after bariatric procedures, along with its indications, methods, and outcome. A total of 87 patients underwent endoscopic stenting after a bariatric procedure from January 1, 2013, and December 31, 2016, in four bariatric centers. Previous bariatric procedures included Roux-en-Y gastric bypass (RYGB) (n = 33), sleeve gastrectomy (n = 50), duodenal switch (DS, n = 2), and vertical banded gastroplasty (VBG, n = 2). Mean age at intervention was 42.6 ± 10.0years old, and mean body mass index was 41.6 ± 4.0kg/m2 at the time of bariatric procedure. Reasons for stenting included sleeve leakage (n = 48), gatrojejunostomy (GJ) leakage (n = 21), stricture (n = 8), staple-line disruption (n = 7), and obstruction at the site of ring (n = 2). Migration occurred in 19.5% (n = 17) of patients undergoing stent placement and required repositioning or replacement of stents. Stenosis occurred in 13.8% of patients, which required endoscopic dilatation after stent removal. Stents may be useful and effective in managing complications after different bariatric procedures, including RYGB and LSG.