A382 Endoscopic management of chronic gastrojejunal anasotomic stricture after gastric bypass surgery

Bariatric surgery procedures performed has risen with the increase in obesity since 2000. Laparoscopic bypass surgery is one of the most commonly performed operations for surgical weight loss. Chronic gastrojejunal anastomotic (G-J) strictures pose a difficult clinical management challenge. A 51-year-old female with a significant medical history of morbid obesity (BMI 49.9) was medically cleared to undergo laparoscopic Roux-en-Y gastric bypass (RYGB). Thirteen months following an uncomplicated laparoscopic bypass, she developed a G-J stricture. Serial dilations failed as a therapeutic option. Balloon dilation resulted in a perforation of her G-J anastomosis requiring urgent treatment. A fully-covered expandable metal stent was utilized and resolved the perforation within 48 hours of placement. Serial balloon dilation is an accepted and effective treatment for G-J stricture after Roux-en-Y gastric bypass. In this case, repeated long-term dilation resulted in a perforation of G-J stricture. The patient’s leak and stricture were successfully treated utilizing a fully-covered expandable endoscopic metal stent and propose endoluminal stenting may be an effective treatment for chronic G-J stricture after Roux-en-Y gastric bypass.