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Management of Laparoscopic Sleeve Gastrectomy: Narrowing and Stenosis 

Management of Laparoscopic Sleeve Gastrectomy: Narrowing and Stenosis
Chapter:
Management of Laparoscopic Sleeve Gastrectomy: Narrowing and Stenosis
Author(s):

Alex Ordoñez

, Emanuele Lo Menzo

, Samuel Szomstein

, and Raul J. Rosenthal

DOI:
10.1093/med/9780190608347.003.0031
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date: 09 December 2021

The increased popularity of laparoscopic sleeve gastrectomy (LSG) can be attributed to its technical simplicity, coupled with its good results. Strictures after LSG are reported with a low incidence. The reasons for strictures are mostly mechanical and are related to the size of the bougie utilized, the proximity of the stapler to the bougie, and twisting of the stapler along the longitudinal axis. Mild cases of strictures immediately postoperatively are typically the result of temporary edema and can be managed expectantly. Strictures that do not resolve quickly with time or that present later on will likely need endoscopic intervention or even reoperation. Among the surgical interventions, sleeve seromyotomy has been reported to have success; however, in refractory cases, the conversion to Roux-en-Y gastric bypass is necessary.

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