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Endoscopic Management of Bariatric Surgery Complications

Cai, Jennifer X. MD, MPH; Schweitzer, Michael A. MD; Kumbhari, Vivek MD

Surgical Laparoscopy Endoscopy & Percutaneous Techniques: April 2016 - Volume 26 - Issue 2 - p 93–101
doi: 10.1097/SLE.0000000000000230
Review Articles

Obesity is a global epidemic that has significant impact on morbidity, mortality, and rising health care costs. In morbidly obese patients with body mass index >40 kg/m2, bariatric surgery is a grade A recommendation and is associated with up to 40% reduction in premature death. Increasingly, endoscopy is seen as a safer and more cost-effective approach to the management of weight loss surgery complications including gastrointestinal bleeding, development of anastomotic ulcers, staple-line leaks and fistulas, strictures, weight regain, bezoars, choledocholithiasis, and gastric band erosion and slippage. Many endoscopic interventions currently rely on a combination of specialized equipment, such as stents, suture systems, clips, and balloon dilators to successfully treat these issues. This article will present common postoperative complications in bariatric surgery, discuss the latest evidence for their endoscopic management, and offer future directions in the endoluminal therapy of obese patients.

*Department of Medicine, Division of Gastroenterology and Hepatology

Department of Surgery, The Johns Hopkins Medical Institutions, Baltimore, MD

Full verbal and written informed consent has been obtained from the patients for submission of this manuscript for publication.

The authors declare no conflicts of interest.

Reprints: Vivek Kumbhari, MD, Director of Bariatric Endoscopy, Johns Hopkins Medicine, Division of Gastroenterology and Hepatology, 4940 Eastern Avenue, A Building, 5th Floor Baltimore, MD, 21224 (e-mail:

Received March 26, 2015

Accepted November 17, 2015

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