# Lumen Apposing Metal Stents for Gastrojejunal Anastomotic Stricture Following Metabolic Bariatric Surgery

## TL;DR

This study explores the use of lumen-apposing metal stents as a treatment option for gastrojejunal anastomotic strictures after bariatric surgery.

## Contribution

The study evaluates the effectiveness and safety of lumen-apposing metal stents for treating post-bariatric surgery strictures.

## Key findings

- All patients achieved clinical success with zero perforations.
- Technical success was achieved in 95% of cases.
- Five percent of patients ultimately required surgical revision.

## Abstract

The standard of care for gastrojejunal anastomotic stricture following metabolic bariatric bypass surgery is endoscopic balloon dilatation, with revisional surgery as a last line option. The use of lumen-apposing metal stents is expanding to include many gastrointestinal benign and malignant causes in selected cases. They may provide an additional treatment option for post-bypass strictures.

A single centre, retrospective outcomes analysis was performed over a 3-year period of patients with gastrojejunal anastomotic stricture following metabolic bariatric surgery that was treated with a lumen-apposing metal stent. Primary outcomes assessed were clinical success and perforation. Multiple secondary outcomes were assessed regarding safety and endoscopy use.

Of 88 patients that had lumen-apposing metal stents placed, 20 satisfied selection criteria. Eleven patients (55%) had at least one balloon dilatation prior to stent placement. All patients achieved clinical success 20 (100%) with zero perforations. Technical success was achieved in 19 patients (95%). There were four (20%) recurrent strictures, two stent migrations (10%) (with no associated complication), and one in-stent food bolus obstruction (5%). One patient ultimately required surgical revision (5%). Three patients had endoscopy within 30 days of stent removal (15%), and five patients required unplanned endoscopy with the stent in situ (25%).

Lumen-apposing metal stents within our study show potential as another treatment option for gastrojejunal anastomotic stricture following gastric bypass.

The online version contains supplementary material available at 10.1007/s11695-025-07891-9.