Espinel Jesús, Pinedo Eugenia
Jesús Espinel, Endoscopy Unit, Gastroenterology Department, Hospital de León, 24071 León, Spain.
World J Gastrointest Endosc. 2012 Jul 16;4(7):290-5. doi: 10.4253/wjge.v4.i7.290.
Gastric bypass is a treatment option for morbid obesity. Stenosis of the gastrojejunal anastomosis is a recognized complication. The pathophysiological mechanisms involved in the formation of stenosis are not well known. Gastrojejunal strictures can be classified based on time of onset, mechanism of formation, and endoscopic aspect. Diagnosis is usually obtained by endoscopy. The two main treatment alternatives for stomal stricture are: endoscopic dilatation (balloon or bouginage) and surgical revision (open or laparoscopic). Both techniques of dilation [through-the-scope (TTS) balloon dilators, Bougienage dilators] are considered safe, effective, and do not require hospitalization. The optimal technique for dilation of stomal strictures remains to be determined, but many authors prefer the use of TTS balloon catheters. Most patients can be successfully treated with 1 or 2 sessions. The need for reconstructive surgery of a stomal stricture is extremely rare.
胃旁路手术是治疗病态肥胖的一种选择。胃空肠吻合口狭窄是一种公认的并发症。狭窄形成所涉及的病理生理机制尚不清楚。胃空肠狭窄可根据发病时间、形成机制和内镜表现进行分类。诊断通常通过内镜检查获得。胃造口狭窄的两种主要治疗选择是：内镜扩张（球囊或探条扩张）和手术修复（开放或腹腔镜手术）。两种扩张技术[经内镜（TTS）球囊扩张器、探条扩张器]都被认为是安全、有效的，且无需住院。胃造口狭窄的最佳扩张技术仍有待确定，但许多作者更喜欢使用TTS球囊导管。大多数患者通过1或2次治疗即可成功治愈。胃造口狭窄需要进行重建手术的情况极为罕见。
