**4.3 Stenosis**

Stenosis can result from the surgical technique or ischemia with subsequent stricture development. Clinically, significant stenosis occurs in 0.5–3.5% of cases, most often in a short segment located at mid-body, near the incisura [78]. Diagnosis is made by upper gastrointestinal contrast studies. Initial management is endoscopic balloon dilatation, probably requiring 2–4 dilation sessions, with 95–100% long-term success rates [79]. However, there is a 2–5% risk of perforation associated with dilation [72]. For cases where endoscopic dilation fails, the options include endoscopic stenting or conversion to RYGB [80].
