Influence of pouch and stoma size on weight loss after gastric bypass.

Background: Enlargement of the gastric pouch and/or gastrojejunostomy after Roux-en-Y gastric bypass (RYGB) is postulated to be the antecedent to suboptimal weight loss or weight regain. The present study evaluated the gastric pouch and stoma dimensions in RYGB patients and correlated them with the weight loss outcomes.

Methods: Patients who underwent upper endoscopy for investigation of gastrointestinal symptoms or weight regain after RYGB were identified.

Endoscopic stent management of leaks and anastomotic strictures after foregut surgery.

Background: Anastomotic complications after upper gastrointestinal surgery present an arduous therapeutic challenge. Avoiding revisional surgery is desirable and might be possible with the advent of endoscopically placed stents. We reviewed our experience with endoscopic stent management of anastomotic complications after esophagogastric surgery.

Endoscopic findings and outcomes of revisional procedures for patients with weight recidivism after gastric bypass.

Background: Significant weight regain occurs for 10% to 20% of patients after Roux-en-Y gastric bypass (RYGB). Potential causative factors include anatomic abnormalities such as enlargement of the gastric pouch and gastrojejunostomy (GJ). This report describes endoscopic findings for patients referred for investigation of weight regain and presents the outcomes of revisional therapy for patients with abnormal anatomy.

Successful management of gastrojejunal strictures after gastric bypass: is timing important?

Background: Endoscopic balloon dilation is an effective treatment of gastrojejunal (GJ) strictures after Roux-en-Y gastric bypass (RYGB), although its success might depend on the point at which they occur postoperatively. We hypothesized that "late" strictures (≥90 d after RYGB) might be less amenable to balloon dilations than "early" strictures occurring within 90 days postoperatively.

Methods: A review of a prospectively maintained database at a bariatric center was conducted to identify all patients who underwent upper endoscopy (UE) for investigation of gastrointestinal symptoms after RYGB.

[State-art: diagnosis and management in pancreas divisum].

Pancreas divisum (PD), the most common congenital variant of pancreatic duct anatomy, occurs when the ductal systems of the ventral and dorsal pancreatic ducts fail to fuse during the second month of gestation. With non-union of the ducts, the major portion of the pancreatic exocrine secretion enters the duodenum by way of the dorsal duct and minor papilla. It has been generally accepted that a relative obstruction to pancreatic exocrine secretory flow through the minor duct and minor papilla could result in pancreatitis in small numbers of patients with PD.

Droperidol, when used for sedation during ERCP, may prolong the QT interval.

Background: Droperidol is a known effective adjunctive agent for sedation/analgesia during endoscopic procedures, particularly in patients who are difficult to sedate with narcotics and benzodiazepines alone. However, the Food and Drug Administration (FDA) warning about potential droperidol-related fatal cardiac arrhythmias, issued in December 2001, led to concern about its safety in current clinical practice.

Objective: In this study, we evaluated the effects of droperidol on the Bazett's corrected QT interval (QTcB) administered to patients undergoing ERCP and frequency of cardiac arrhythmias.