Endoscopic therapies for bariatric surgery complications.

IF 2.6 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Current Opinion in Gastroenterology Pub Date : 2024-11-01 Epub Date: 2024-06-14 DOI:10.1097/MOG.0000000000001047

Abdelrahman Yakout, Enrique F Elli, Vivek Kumbhari, Nader Bakheet

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引用次数: 0

Abstract

Purpose of review: The aim of this review is to present the current state of the field, highlight recent developments, and describe the clinical outcomes of endoscopic therapies for bariatric surgery complications.

Recent findings: The field of interventional endoscopy now presents a range of minimally invasive procedures for addressing postbariatric complications. Lumen-opposing metal stents have emerged as a reliable solution for managing gastrojejunal strictures following Roux-en-Y gastric bypass, whether with or without associated leaks. Additionally, they serve as a conduit for performing endoscopic retrograde cholangiopancreatography (ERCP) post-RYGB via EUS-directed ERCP (EDGE). Gastric peroral endoscopic myotomy, originally designed for gastroparesis, has demonstrated effectiveness in treating postgastric sleeve stenosis, particularly the challenging helical stenosis cases. Furthermore, innovative endoscopic antireflux techniques are showing encouraging outcomes in addressing gastroesophageal reflux disease (GERD) following sleeve gastrectomy. Additionally, several modifications have been proposed to enhance the efficacy of transoral outlet reduction (TORe), originally developed to treat weight regain due to gastrojejunal anastomotic issues post-RYGB.

Summary: Endoscopic management of bariatric surgery complications is continuously evolving. The development of new techniques and devices allows endoscopists to provide novel, minimally invasive alternatives that were not possible in the near past. Many techniques, however, are limited to expert centers because they are technically demanding, and specialized training in bariatric endoscopy is still required.

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减肥手术并发症的内窥镜疗法。

综述的目的：本综述旨在介绍该领域的现状、最新进展，并描述内窥镜疗法治疗减肥手术并发症的临床效果：最近的研究结果：介入内镜领域目前有一系列微创手术可用于治疗减肥术后并发症。腔隙对抗金属支架已成为治疗鲁氏-Y 胃旁路术后胃空肠狭窄（无论是否伴有渗漏）的可靠解决方案。此外，它们还是通过 EUS 导向 ERCP（EDGE）在 RYGB 术后进行内镜逆行胰胆管造影术（ERCP）的通道。胃口周围内镜肌切开术最初是为胃痉挛而设计的，但在治疗胃袖状切除术后狭窄，特别是具有挑战性的螺旋狭窄病例方面已显示出效果。此外，创新的内镜抗反流技术在治疗袖状胃切除术后胃食管反流病（GERD）方面也取得了令人鼓舞的成果。此外，还提出了几项改进措施，以提高经口出口缩窄术（TORe）的疗效，该技术最初是为了治疗 RYGB 术后因胃空肠吻合问题导致的体重反弹而开发的。新技术和新设备的开发使内镜医师能够提供新颖、微创的替代方法，这在过去是不可能的。然而，由于技术要求较高，许多技术仅限于专家中心使用，而且仍然需要对减肥内镜进行专门培训。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Current Opinion in Gastroenterology 医学-胃肠肝病学

CiteScore

5.30

自引率

0.00%

发文量

137

审稿时长

6-12 weeks

期刊介绍： Published bimonthly and offering a unique and wide ranging perspective on the key developments in the field, each issue of Current Opinion in Gastroenterology features hand-picked review articles from our team of expert editors. With twelve disciplines published across the year – including gastrointestinal infections, nutrition and inflammatory bowel disease – every issue also contains annotated references detailing the merits of the most important papers.