Gastrobronchial Fistula in Sleeve Gastrectomy and Roux-en-Y Gastric Bypass—A Systematic Review

Abstract

Gastrobronchial fistula (GBF) is a rare surgical complication after bariatric surgery. We aimed to identify the clinical aspects of GBF and establish diagnostic and treatment strategies. A literature search was conducted in December 2013, in the PubMed electronic database. Eleven studies were selected, comprising a total of 36 patients. Most patients presented with a gastric leak prior to the diagnosis of GBF. Mean period until diagnosis was 7.2 months, and main presenting symptoms were productive cough (n = 13) and subphrenic abscess (n = 12). Endoscopic treatment was successful in 18 out of 20 patients, with minimal complication. Surgical treatment was successful in 17 cases with significant complications. GBF can be effectively treated with both endoscopic and surgical approach; however, surgical treatment can be associated with more complication.

A Thoracoabdominal Approach for Gastrobronchial Fistula Repair Post Complicated Laparoscopic Sleeve Gastrectomy (LSG)

“…There is a surge in bariatric surgeries, the most common ones being Roux-en-Y gastric bypass and LSG procedures [2]. The most prevalent acute complications are gastric fistulas and hemorrhage, whereas the most prevalent long-term complications are gastric strictures and gastroesophageal reflux disease [2].…”

“…The most prevalent acute complications are gastric fistulas and hemorrhage, whereas the most prevalent long-term complications are gastric strictures and gastroesophageal reflux disease [2].…”

“…GBF was classified by Moeller and Carpenter in 1985 [2]. Its relation to bariatric surgery was established in 2006 [3].…”

“…Its relation to bariatric surgery was established in 2006 [3]. The exact incidence has not been established but some studies show a range between 0.2% [2] and 0.37% [3].…”

“…With the increase in number of patients undergoing bariatric surgeries, physicians must be aware of complications. There is no consensus on the management of GBFs, which is further complicated by lack of sufficient literature [2]. Herein, we report the case of a 36-year-old woman who underwent a LSG procedure, complicated by a GBF that was managed through a thoracoabdominal approach.…”