Stricture after laparoscopic sleeve gastrectomy – case report

One of the specific complications associated with laparoscopic sleeve gastrectomy is sleeve stenosis. It takes place mostly at the incisura angularis. We describe a 17-year-old patient with a stricture of sleeve and symptoms of severe gastrointestinal obstruction immediately after surgery. The patient underwent relaparoscopy on the 21st postoperative day, followed by two sessions of endoscopic dilatation using balloons with a diameter of 16 and 18 mm, respectively, on the 28th and the 41st postoperative day. Relief of clinical symptoms was obtained despite persisting mediocre degree of stricture in the radiological image. The study presents the course and outcomes of treatment, and discusses the basic issues related to the strictures after laparoscopic sleeve gastrectomy basing on the available literature. Treatment of the strictures after sleeve gastrectomy is generally long-term and difficult and requires a lot of experience from the surgical and endoscopic team. The choice of the method of dealing with this complication depends on experience, the length of stricture and its location. Development of a surgical technique preventing the occurrence of stricture is of great importance.