Balloon dilation for the treatment of stomal stenosis complicating gastric surgery for morbid obesity.

In a retrospective analysis, we evaluated our results with endoscopic dilation of enterostomy stenoses that complicated gastric procedures performed for the treatment of morbid obesity. Of 541 patients who underwent a gastric procedure for treatment of morbid obesity, we found 19 patients in whom endoscopic dilations of stenoses had been attempted. We also include three patients who had surgery elsewhere but who underwent dilations at our institution. Fourteen had stenoses complicating gastric bypass with Roux-en-Y anastomoses, and eight had stenoses complicating a gastroplasty (gastrogastrostomy). Two different types of dilation were attempted during the interval reviewed--Fogarty balloon dilations and Grüntzig balloon dilations. None of the eight patients with gastroplasties benefited from the attempted dilation, but 10 of the 14 patients with stenoses complicating gastric bypasses have done well. We found no significant difference between Fogarty and Grüntzig balloon dilations. We conclude that balloon dilation is an effective means of treating stenosis that complicates gastric bypass performed with Roux-en-Y anastomoses in cases of morbid obesity.