Endoscopic Dilation of Post-Sleeve Gastrectomy Stenosis: Long-Term Efficacy and Safety Results

Aims Post-sleeve gastrectomy (SG) stenoses occur in about 5 % of cases. Hydrostatic dilation (HD) and pneumatic dilation (PD) have been proposed as treatments, but efficacy data remain scarce. The objectives of this study were to evaluate the safety and the initial and long-term efficacy of endoscopic balloon dilation for post-SG stenosis according to different mechanisms of post-SG stenosis.

Methods This retrospective study in a referral endoscopy center included patients with symptomatic post-SG stenosis treated with endoscopic balloon dilation (EBD). Stenosis was defined as “organic” if luminal narrowing was evident, “functional” for a deformation, or “combined”.

Endoscopic treatment consisted of ≥1 HD (15-20 mm) and/or ≥1 PD (30-35 mm). Initial success was defined as improvement of stenosis-related symptoms at 1 month and long-term success as persistence of improvement at last follow-up.

Results Forty-four patients (73 % women; mean age 45.5±11 years; mean follow-up 26±23months) underwent EBD between 2013 and 2019. HD and PD were used in 15 (34 %) and 29 (66 %) patients, respectively, (mean dilation number: 1.8±1.1). Post-SG stenoses were considered organic in 10 (23 %), functional in 21 (48 %), and combined in 13 (29 %) patients. Initial success was achieved in 42 (96 %) patients, while 35 (80 %) patients had no symptom recurrence at last follow-up. Perforation occurred in one patient. HD was more frequently used in organic stenoses (8/10), while PD in functional and combined stenoses (18/21 and 9/13, respectively; p<0.001). Rates of success did not differ by type of stenosis.

Conclusions Endoscopic dilation is an effective treatment for post-SG stenoses, providing long-term symptom relief. PD should be preferred in cases of functional stenoses, and HD used for organic stenoses.

Citation: Lorenzo D, Gkolfakis P, Lemmers A et al. eP153 ENDOSCOPIC DILATION OF POST-SLEEVE GASTRECTOMY STENOSIS: LONG-TERM EFFICACY AND SAFETY RESULTS. Endoscopy 2021; 53: S146.

Publication History

Article published online:
19 March 2021