Our Summary

This study looks at a specific complication of a type of weight loss surgery called laparoscopic sleeve gastrectomy (LSG), known as gastric stenosis (GS), which is a narrowing of the stomach. The researchers reviewed the treatment and prevention of GS in 927 patients who had the surgery at their hospital in Taiwan between 2007 and 2015.

They found that 0.8% of patients developed GS. On average, symptoms showed up about 14 days after surgery, treatment using a procedure called endoscopic dilation occurred about 21 days after surgery, and if needed, a second surgery happened about 36 days after the original surgery.

Most of the GS cases were found in a specific part of the stomach. Only one patient responded well to the endoscopic dilation procedure alone. The other eight patients needed a second surgery. After these additional procedures, none of the patients had recurrent GS symptoms.

In 2013, the researchers changed their surgical techniques. After this change, none of the 489 patients treated had GS. The researchers concluded that a combination of endoscopic intervention and possible follow-up surgery is crucial for managing GS. They also emphasized the importance of standardized surgical procedures to prevent GS.

FAQs

  1. What is gastric stenosis (GS) and how common is it in patients who undergo laparoscopic sleeve gastrectomy (LSG)?
  2. How effective is the endoscopic dilation procedure in treating GS, and how often is a second surgery required?
  3. Did the change in surgical techniques in 2013 impact the occurrence of GS in patients?

Doctor’s Tip

A helpful tip a doctor might tell a patient about gastric sleeve surgery is to follow up closely with their healthcare team after the procedure to monitor for any potential complications, such as gastric stenosis. It is important to report any new or worsening symptoms, such as difficulty swallowing or persistent nausea, to their healthcare provider promptly. Following post-operative guidelines, such as dietary recommendations and exercise plans, can also help prevent complications and promote successful weight loss outcomes.

Suitable For

Patients who are typically recommended for gastric sleeve surgery include those who have a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as type 2 diabetes, sleep apnea, or high blood pressure. Additionally, patients who have not been successful with other weight loss methods such as diet and exercise may also be recommended for gastric sleeve surgery. It is important for patients to undergo a thorough evaluation by a healthcare provider to determine if they are a good candidate for this type of weight loss surgery.

Timeline

Before gastric sleeve surgery, a patient typically goes through a series of consultations with their healthcare provider to determine if they are a suitable candidate for the procedure. They may undergo various tests and evaluations to assess their overall health and readiness for surgery.

After the surgery, patients will typically spend a few days in the hospital for monitoring and recovery. They will gradually transition from a liquid diet to pureed foods and eventually solid foods over the course of several weeks. Follow-up appointments with their healthcare provider will be scheduled to monitor their progress and address any concerns or complications that may arise.

In the case of gastric stenosis following gastric sleeve surgery, symptoms may appear around two weeks post-surgery. Treatment with endoscopic dilation may be necessary around three weeks post-surgery, with the possibility of a second surgery around five weeks post-surgery if needed.

Overall, the timeline for a patient before and after gastric sleeve surgery involves a thorough evaluation process prior to the surgery, followed by a period of recovery and monitoring post-surgery to ensure successful outcomes and address any potential complications.

What to Ask Your Doctor

  1. What is gastric sleeve surgery and how does it work as a weight loss procedure?
  2. What are the potential complications of gastric sleeve surgery, including gastric stenosis?
  3. What are the symptoms of gastric stenosis and when should I seek medical attention if I experience them?
  4. How common is gastric stenosis after gastric sleeve surgery?
  5. How is gastric stenosis diagnosed and treated?
  6. What is the success rate of endoscopic dilation for treating gastric stenosis?
  7. What are the potential risks and side effects of endoscopic dilation and follow-up surgery for gastric stenosis?
  8. Are there any changes in surgical techniques or practices that can help prevent gastric stenosis after gastric sleeve surgery?
  9. What is the long-term outlook for patients who develop gastric stenosis after gastric sleeve surgery?
  10. Are there any dietary or lifestyle changes I should make to reduce my risk of developing gastric stenosis after gastric sleeve surgery?

Reference

Authors: Chang PC, Tai CM, Hsin MC, Hung CM, Huang IY, Huang CK. Journal: Surg Obes Relat Dis. 2017 Mar;13(3):385-390. doi: 10.1016/j.soard.2016.09.014. Epub 2016 Sep 16. PMID: 27865815