BACKGROUND Laparoscopic one anastomosis gastric bypass has become a prominent bariatric procedure. Yet, early and late complications, primarily leaks and strictures, are not uncommon. This study summarizes our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications. METHODS This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention. RESULTS Nine patients presented with acute or early leaks: 5 (56%) had staple-line leaks, 3 (33%) had anastomotic leaks and 1 (11%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44%). Overall 5 patients (56%) with acute/ early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilation. CONCLUSION Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.

中文翻译：

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腹腔镜一吻合术胃旁路术后早期渗漏和狭窄的内镜治疗。

背景技术腹腔镜下一种吻合术胃旁路术已成为一种重要的减肥手术。然而，早期和晚期并发症（主要是泄漏和狭窄）并不少见。这项研究总结了我们的内镜治疗腹腔镜吻合术胃旁路手术并发症的经验。方法这是一项回顾性研究，对2015年至2017年间转诊至我院的腹腔镜手术后一位吻合术的胃搭桥并发症进行回顾性研究。针对每种情况量身定制治疗方法，包括完全覆盖的自膨胀金属支架，纤维蛋白胶，切开术，带尾纤支架的内部引流，通过观察和气动扩张。成功的定义是在没有肠内或肠胃外支持或进一步手术干预的情况下恢复口腔营养。结果9例患者出现急性或早期渗漏：5个（56％）发生吻合钉线漏出，3例（33％）吻合口漏出，1例（11％）两者均漏出。全部用支架治疗。辅助内窥镜引流治疗4例（44％）。总共5例有急性/早期渗漏的患者（56％）完全康复，包括所有3例吻合口漏和这两种渗漏的患者，但仅有1/5的吻合钉腔渗漏（20％）。渗漏组并发症发生率达到22％。8例出现狭窄，7例发生吻合，1例由于残余的胃部未对准。所有吻合口狭窄均已成功扩张。但是，囊袋狭窄的患者在3次失败的扩张尝试后需要转换为Roux-en-Y胃旁路手术。结论内窥镜治疗腹腔镜一期吻合术的胃旁路术并发症相对安全有效。