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- Title
Role of Endoscopic Internal Drainage in Treating Gastro-Bronchial and Gastro-Colic Fistula After Sleeve Gastrectomy.
- Authors
D'Alessandro, Alessandra; Galasso, Giovanni; Zito, Francesco Paolo; Giardiello, Cristiano; Cereatti, Fabrizio; Arienzo, Roberto; Pacini, Filippo; Chevallier, Jean-Marc; Donatelli, Gianfranco
- Abstract
Background : Gastro-bronchial and gastro-colic fistulas (GB-GC) represent a rare, but serious complication after laparoscopic sleeve gastrectomy (LSG). The aim of this study is to evaluate the efficacy of endoscopic first-line approach with endoscopic internal drainage (EID) by inserting double pigtail stents (DPS) Methods: We retrospectively analyzed data from 40 consecutive patients referred at two tertiary centers for gastro-bronchial (N=30) and gastrocolic (N=10) fistulas following LSG. Nineteen patients previously experienced emergency surgical drainage. The mean interval between the index surgery and endoscopic fistula treatment was 265.6±521 days. Results: Healing of the fistulous tract was achieved in 19 patients (47.5%), with complete resolution at an average follow-up of 16 months. Mean time of treatment duration was 157.8±141 days with 5.0±2.9 endoscopic sessions. No major adverse events were registered. Conclusions: Despite complete fistula healing was achieved in less than 50% of our population, EID for GB/GC fistula after LSG still represents the most conservative approach with low complications rate. Previous surgical drainage seems to be a positive prognostic factor for endoscopic healing. While the longer the interval between the index surgery and endoscopic treatment, the lower was the rate of treatment success.
- Subjects
SLEEVE gastrectomy; FISTULA; SURGICAL drainage; SURGICAL emergencies; ENDOSCOPIC surgery; PROGNOSIS
- Publication
Obesity Surgery, 2022, Vol 32, Issue 2, p342
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-021-05794-z