Endoscopic Treatment Options in Patients With Gastrojejunal Anastomosis Stricture Following Roux-en-Y Gastric Bypass

The proportion of obese individuals continues to increase worldwide. Bariatric surgery remains the only evidence-based treatment strategy to produce marked weight loss. Roux-en-Y gastric bypass is an effective and common bariatric surgical procedure offered to obese patients. However, a small percentage of individuals can develop narrowing or stricture formation of the gastrojejunal anastomosis. Endoscopic treatment of gastrojejunostomy (GJ) is preferred compared to surgical revision, as it is less invasive. The endoscopic treatment strategy most common employed is balloon dilatation. Endoscopic balloon dilatation is successful in majority of cases with low morbidity, however multiple dilatation may be required. Other endoscopic strategies such as incisional therapy has been successful in treating other gastrointestinal anastomotic strictures, however remain to be evaluated in post-RYGB GJ strictures. Further research is needed to determine the effectiveness of incision therapy and other endoscopic treatment strategies compared to endoscopic balloon dilatation.