Advertisement

Endoscopic neogastrogastrostomy in a postgastric bypass patient by application of an endoscopic antegrade–retrograde rendezvous technique

      The patient, a 45-year-old woman, initially underwent Roux-en-Y gastric bypass for morbid obesity. Three years later, it was complicated by a gastrojejunostomy ulcer with perforation requiring local repair. Additional complications with ischemic bowel and subsequent surgical revisions resulted in complete gastric outlet obstruction. A venting gastrostomy tube was placed in the gastric pouch, and a feeding gastrostomy tube was surgically placed in the gastric remnant. After some time, the patient strongly expressed her desire to eat orally. Because of the previous surgical complications and scar tissue, the surgical team requested an endoscopic attempt to reconnect the gastric pouch and excluded gastric remnant.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to Surgery for Obesity and Related Diseases
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      References

        • Barba C.A.
        • Butensky M.S.
        • Lorenzo M.
        • Newman R.
        Endoscopic dilation of gastroesophageal anastomosis stricture after gastric bypass.
        Surg Endosc. 2003; 17: 416-420
        • Van Twisk J.J.
        • Brummer R.M.
        • Manni J.J.
        Retrograde approach to pharyngoesophageal obstruction.
        Gastrointest Endosc. 1998; 48: 296-299
        • Davies M.
        • Satyadas T.
        • Akle C.A.
        • Kirkham J.S.
        Combined endoscopic approach for the management of a difficult recto-sigmoid anastomotic stricture.
        Int Surg. 2004; 89: 76-79
        • Maple J.T.
        • Petersen B.T.
        • Baron T.H.
        • et al.
        Endoscopic management of radiation-induced complete upper esophageal obstruction with an antegrade–retrograde rendezvous technique.
        Gastrointest Endosc. 2006; 64: 822-828
        • Moyer M.T.
        • Stack Jr, B.C.
        • Mathew A.
        Successful recovery of esophageal patency in 2 patients with complete obstruction by using combined antegrade retrograde dilation procedure, needle knife, and EUS.
        Gastrointest Endosc. 2006; 64: 789-792
        • Baumgart D.C.
        • Veltzke-Schlieker W.
        • Wiedenmann B.
        • Hintz R.E.
        Successful recanalization of a completely obliterated esophageal stricture by using an endoscopic rendezvous maneuver.
        Gastrointest Endosc. 2005; 61: 473-475
        • De Lusong M.A.
        • Shah J.N.
        • Soetikno R.
        • Binmoeller K.F.
        Treatment of a completely obstructed colonic anastomotic stricture by using a prototype forward-array echoendoscope and facilitated by SpyGlass (with videos).
        Gastrointest Endosc. 2008; 68: 988-992
        • Guan Y.S.
        • Sun L.
        • Li X.
        • Zheng X.H.
        Successful management of a benign anastomotic colonic stricture with self-expanding metallic stents: a case report.
        World J Gastroenterol. 2004; 10: 3534-3536
        • Piccinni G.
        • Nacchiero M.
        Management of narrower anastomotic colonic strictures: case report and proposal technique.
        Surg Endosc. 2001; 15: 1227
        • Wagh M.S.
        • Forsmark C.E.
        Endoscopic creation of a gastrogastric conduit for reversal of gastric bypass.
        Gastrointest Endosc. 2011; 74: 932-933