Dysphagia after vertical sleeve gastrectomy: Evaluation of risk factors and assessment of endoscopic intervention.
Dysphagia after vertical sleeve gastrectomy: Evaluation of risk factors and assessment of endoscopic intervention.
- 2016
CONCLUSION: Narrowing of the gastric sleeve and gastric sleeve stenosis are common after VSG. Endoscopic balloon dilatations of the gastric sleeve resolves dysphagia in 69% of patients. METHODS: VSG is being performed more frequently worldwide as a treatment for medically-complicated obesity, and dysphagia is common post-operatively. We hypothesize that post-operative dysphagia is related to underlying medical conditions or narrowing of the gastric sleeve. This is a retrospective, single institution study of consecutive patients who underwent sleeve gastrectomy from 2013 to 2015. Patients with previous bariatric procedures were excluded. Narrowing of a gastric sleeve includes: inability to pass a 9.6 mm gastroscope due to stenosis or sharp angulation or spiral hindering its passage. RESULTS: Of 400 consecutive patients, 352 are included; the prevalence of dysphagia is 22.7%; 33 patients (9.3%) have narrowing of the sleeve with 25 (7.1%) having sharp angulation or a spiral while 8 (2.3%) have a stenosis. All 33 patients underwent balloon dilatation of the gastric sleeve and dysphagia resolved in 13 patients (39%); 10 patients (30%) noted resolution of dysphagia after two additional dilatations. In a multivariate model, medical conditions associated with post-operative dysphagia include diabetes mellitus, symptoms of esophageal reflux, a low whole blood thiamine level, hypothyroidism, use of non-steroidal anti-inflammatory drugs, and use of opioids.
English
1007-9327
*Deglutition Disorders/et [Etiology]
*Deglutition Disorders/th [Therapy]
*Endoscopy, Gastrointestinal/mt [Methods]
*Gastrectomy/ae [Adverse Effects]
*Obesity/su [Surgery]
Adult
Aged
Chi-Square Distribution
Constriction, Pathologic
Deglutition Disorders/di [Diagnosis]
Dilatation
Endoscopy, Gastrointestinal/ae [Adverse Effects]
Female
Humans
Hydrostatic Pressure
Logistic Models
Male
Middle Aged
Multivariate Analysis
Obesity/di [Diagnosis]
Odds Ratio
Retrospective Studies
Risk Factors
Treatment Outcome
Young Adult=520 \\
AIM: To evaluate the risks of medical conditions, evaluate gastric sleeve narrowing, and assess hydrostatic balloon dilatation to treat dysphagia after vertical sleeve gastrectomy (VSG).
MedStar Washington Hospital Center
Medicine
Medicine/Gastroenterology
Medicine/Gastroenterology
Medicine/General Internal Medicine
Journal Article
CONCLUSION: Narrowing of the gastric sleeve and gastric sleeve stenosis are common after VSG. Endoscopic balloon dilatations of the gastric sleeve resolves dysphagia in 69% of patients. METHODS: VSG is being performed more frequently worldwide as a treatment for medically-complicated obesity, and dysphagia is common post-operatively. We hypothesize that post-operative dysphagia is related to underlying medical conditions or narrowing of the gastric sleeve. This is a retrospective, single institution study of consecutive patients who underwent sleeve gastrectomy from 2013 to 2015. Patients with previous bariatric procedures were excluded. Narrowing of a gastric sleeve includes: inability to pass a 9.6 mm gastroscope due to stenosis or sharp angulation or spiral hindering its passage. RESULTS: Of 400 consecutive patients, 352 are included; the prevalence of dysphagia is 22.7%; 33 patients (9.3%) have narrowing of the sleeve with 25 (7.1%) having sharp angulation or a spiral while 8 (2.3%) have a stenosis. All 33 patients underwent balloon dilatation of the gastric sleeve and dysphagia resolved in 13 patients (39%); 10 patients (30%) noted resolution of dysphagia after two additional dilatations. In a multivariate model, medical conditions associated with post-operative dysphagia include diabetes mellitus, symptoms of esophageal reflux, a low whole blood thiamine level, hypothyroidism, use of non-steroidal anti-inflammatory drugs, and use of opioids.
English
1007-9327
*Deglutition Disorders/et [Etiology]
*Deglutition Disorders/th [Therapy]
*Endoscopy, Gastrointestinal/mt [Methods]
*Gastrectomy/ae [Adverse Effects]
*Obesity/su [Surgery]
Adult
Aged
Chi-Square Distribution
Constriction, Pathologic
Deglutition Disorders/di [Diagnosis]
Dilatation
Endoscopy, Gastrointestinal/ae [Adverse Effects]
Female
Humans
Hydrostatic Pressure
Logistic Models
Male
Middle Aged
Multivariate Analysis
Obesity/di [Diagnosis]
Odds Ratio
Retrospective Studies
Risk Factors
Treatment Outcome
Young Adult=520 \\
AIM: To evaluate the risks of medical conditions, evaluate gastric sleeve narrowing, and assess hydrostatic balloon dilatation to treat dysphagia after vertical sleeve gastrectomy (VSG).
MedStar Washington Hospital Center
Medicine
Medicine/Gastroenterology
Medicine/Gastroenterology
Medicine/General Internal Medicine
Journal Article