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

Vivek Kumbhari, Carel W. le Roux, Ricardo V. Cohen

Research output: Contribution to journalReview articlepeer-review

7 Citations (Scopus)


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. Graphical abstract: [Figure not available: see fulltext.]

Original languageEnglish
Pages (from-to)4624–4633
Number of pages10
JournalObesity Surgery
Issue number10
Early online date30 Jul 2021
Publication statusPublished (in print/issue) - 31 Oct 2021

Bibliographical note

Funding Information:
Vivek Kumbhari is a board member of the Association for Bariatric Endoscopy; is a consultant for Apollo Endosurgery, Boston Scientific, Medtronic, Fujifilm, and Pentax Medical; and received research support from ERBE and Apollo Endosurgery. Carel W le Roux serves on advisory boards for novo Nordisk, GI Dynamics, Herbalife, Keyron, Sanofi, Boehringer Ingelheim, and Johnson & Johnson and has received funding from Science Foundation Ireland, Irish Research Council, Health Research Board, and European Foundation for Study of Diabetes. Ricardo V Cohen serves on advisory board for GI Dynamics, Johnson & Johnson, and Keyron, and has received funding from Johnson & Johnson, Medtronic, and GI Dynamics.

Publisher Copyright:
© 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.


  • Bariatric surgery
  • Complications
  • Reflux
  • Stenosis
  • Weight regain


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