Skip to main content
RACS ASC 2024

Use of Lumen Apposing Metal Stents For Gastrojejunostomy Stricture Following Laparoscopic Gastric Bypass Surgery

Poster

Presentation Description

Institution: North Shore Hospital - Auckland, Aotearoa New Zealand

Purpose Lumen Apposing Metal Stents (LAMS) are being increasingly used for many pathologies, especially in biliopancreatic cases. There is a paucity of literature specifically assessing LAMS in bariatric cases. We present our experience utilising LAMS to treat stomal stenosis following gastric bypass. Methodology Consecutive patients between May 2021 to October 2023, with stricture of the Gastrojejunostomy (GJ) following laparoscopic bariatric surgery from a single, high volume, tertiary academic centre were reviewed retrospectively. Outcomes measured were technical success (stent deployment in correct position), clinical success (resolution of symptoms), need for further procedures and adverse events. Results 21 patients were included. Median time between index operation and stent insertion was 57 days (range; 6 to 4887 days). Seven patients had received prior balloon dilatation. Technical success was obtained in 20 patients (95%). Clinical success was achieved in 20 patients (95%). Mean length of time for stent remaining in situ was 71 days, excluding five stents currently in situ and two stents which migrated prior to removal. 10 patients required further endoscopy outside of stent removal. Of these, three required further dilatation and one further stenting. Six required investigatory endoscopy without intervention. The mean follow-up time from the initial stent insertion was 370 days (range 19-898). Two patients required surgical revision. Conclusion Our early experiences demonstrate that the treatment of GJ stenosis with a LAMS is safe and technically feasible. A larger, multi-site series with a longer follow up is required to confirm the efficacy of this approach, but early results are promising.

Speakers

Authors

Authors

Dr Samuel Reddish - , Mr Preekesh Patel - , Mr Andrew Maurice - , Mr Jason Robertson - , Dr Marius Van Rijnsoever - , Mr Michael Booth -