Endoscopic Evaluation and Management of Late Complications After Bariatric Surgery: a Narrative Review

Despite ongoing evolution in technique and a low mortality rate, clinicians may care for patients who suffer late complications (> 90 days of surgery) after bariatric surgery. Endoscopic techniques are used to identify and manage many of the late complications of the two most commonly performed bariatric surgeries: sleeve gastrectomy and Roux-en-Y gastric bypass. Stenosis at the incisura angularis and gastroesophageal reflux disease may occur in patients who have undergone a sleeve gastrectomy. Patients who underwent a Roux-en-Y gastric bypass can suffer marginal ulceration, gastrojejunal anastomotic stricture, and gastro-gastric fistula. Clinicians may also encounter biliary pathologies such as choledocholithiasis, chronic abdominal pain, and weight regain. This narrative review provides an update on the endoscopic evaluation and management of patients with late complications after sleeve gastrectomy or Roux-en-Y gastric bypass.

Automated summary

Despite low mortality rates and advancements in techniques, late complications can still occur after bariatric surgeries, including stenosis and reflux in sleeve gastrectomy patients, and ulceration, stricture, and fistula in Roux-en-Y gastric bypass patients. Clinicians may also encounter biliary pathologies and weight regain in these patients. This narrative review provides an update on the endoscopic evaluation and management of late complications in both types of bariatric surgeries.