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- Title
Endoscopic Fistula-jejunostomy for Chronic Gastro-jejunal Fistula After Sleeve Gastrectomy.
- Authors
Donatelli, Gianfranco; Dumont, Jean-Loup; Guerriero, Ludovica; Perretta, Silvana; Cereatti, Fabrizio; Arapis, Kostantinos; Dammaro, Carmelisa; Fuks, David
- Abstract
Introduction: Proximal gastric leak is one of the most common complications after laparoscopic sleeve gastrectomy (LSG). Endoscopy is the gold standard treatment for acute staple-line leaks. Surgery is the most effective treatment modality in case of chronic fistula.Material and Methods: A 55-year- old man presented an acute leak after LSG. The leak was treated with metal stent deployment with temporary closure. After 6 months, he presented leak recurrence with general sepsis, perigastric-infected collection, and gastro-jejunal fistula.Results: Endoscopic internal drainage (EID) was performed; however, due to fistula persistence, a surgical procedure was proposed. The patient refused revisional surgery; therefore, endoscopic salvage procedure was decided. A fully covered metal stent was deployed in order to bypass the perigastric collection creating an endoscopic gastro-jejunal anastomosis.Conclusion: Revisional surgery is the gold standard treatment for chronic fistula after SG. Endoscopic treatment with SEMS deployment may be a sound option in selected cases especially after failure of other endoscopic techniques or refusal of revisional surgery.
- Subjects
LAPAROSCOPIC surgery; LEAKAGE; FISTULA; JEJUNOSTOMY
- Publication
Obesity Surgery, 2018, Vol 28, Issue 5, p1456
- ISSN
0960-8923
- Publication type
Case Study
- DOI
10.1007/s11695-018-3193-0