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Endoscopic therapies for bariatric surgery complications
Abdelrahman Yakout1, Enrique F Elli2, Vivek Kumbhari1
1Division of Gastroenterology and Hepatology, Department of Medicine.
Current Opinion in Gastroenterology
|June 20, 2024
Summary
Endoscopic therapies offer minimally invasive solutions for bariatric surgery complications like strictures and reflux. New techniques are evolving, providing alternatives for managing post-surgical issues, though specialized training is needed.
Area of Science:
- Bariatric Surgery
- Interventional Endoscopy
- Gastroenterology
Background:
- Bariatric surgery is a common treatment for obesity.
- Complications can arise post-surgery, impacting patient outcomes.
- Traditional management of these complications can be invasive.
Purpose of the Study:
- To review the current landscape of endoscopic therapies for bariatric surgery complications.
- To highlight recent advancements in the field.
- To describe the clinical outcomes associated with these endoscopic interventions.
Main Methods:
- Review of current literature on interventional endoscopic techniques.
- Focus on minimally invasive procedures for post-bariatric complications.
- Analysis of clinical outcomes and efficacy of described techniques.
Main Results:
- Lumen-opposing metal stents are effective for gastrojejunal strictures and leaks post-Roux-en-Y gastric bypass (RYGB).
- Endoscopic retrograde cholangiopancreatography (ERCP) is feasible post-RYGB using EUS-directed ERCP (EDGE).
- Gastric peroral endoscopic myotomy (G-POEM) and endoscopic antireflux techniques show promise for sleeve gastrectomy complications.
- Transoral outlet reduction (TORe) modifications aim to improve efficacy for weight regain.
Conclusions:
- Endoscopic management of bariatric complications is rapidly advancing.
- New techniques and devices offer minimally invasive treatment options.
- Many advanced techniques require specialized training and are best performed at expert centers.
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