Balloon dilatation of gastro-gastrostomy strictures in gastroplasty revisions.

: Several gastric operations have been developed for the control of morbid obesity. Further surgical intervention may be necessary because of failure to lose weight or complications associated with the previous operation such as intolerable reflux symptoms. Revision from a horizontal to a vertical staple line may result in a stenosis at the site of the gastro-gastrostomy. This study examines the authors' experience with balloon dilation of these strictures. Between May, 1981 and September, 1987, 12 of 113 patients who had revision of previous gastric reduction procedures developed either gastro-gastrostomy stenosis or stenosis above the Marlex collar (2 patients). Endoscopic balloon dilatation was attempted in all 12 patients. Eight females and four males (average age, 42 years) had undergone either a previous vertical banded gastroplasty (VBG) (2 patients), gastric bypass, or horizontal gastroplasty as their initial operation. Revision was performed for failure of the initial operation to control weight, obstructive symptoms, or gastroesophageal reflux. Balloon dilatation was possible in 11 of 12 patients. The majority required less than four dilations to alleviate obstructive symptoms. Balloon dilatation is effective in the management of gastro-gastrostomy stenosis following revision of gastric stapling procedures.