Laparoscopic Roux-en-Y fistulojejunostomy as a salvage procedure in patients with chronic gastric leak after sleeve gastrectomy

Laïnas, Panagiotis; Triantafyllou, Evangelia; Amor, Virginie Ben; Savvala, Natalia; Gugenheim, Jean; Dagher, Ibrahim; Amor, Imed Ben

doi:10.1016/j.soard.2022.12.017

Cited by 6 publications

(2 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Open-pore suction devices can be placed endoscopically at the endoluminal fistula opening [ 66 ]. Addition of laparoscopic assistance forms the rendezvous procedure, during which the laparoscopic surgeon assists in accurate identification of the defect and placement of the suction device which is guided at the same time by the endoscopist [ 67 ]. This procedure is thought to be reserved for treatment-resistant leaks, or large leaks requiring laparoscopic washout in addition to attempts for sealing.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Risk Factors and Management Approaches for Staple Line Leaks Following Sleeve Gastrectomy: A Single-Center Retrospective Study of 402 Patients

Verras,

Mulita,

Lampropoulos

et al. 2023

JPM

View full text Add to dashboard Cite

Sleeve gastrectomy (SG) has gained ever-increasing popularity among laparoscopic surgeons involved in bariatric surgery. This single-institution, retrospective cohort study aims to evaluate the prevalence of postoperative staple line leakage (PSLL) after LSG and identify risk factors for its development. We included patient data that underwent LSG at our institution for a span of 17 years—starting in January 2005 and ending in December 2022. We set the investigation of correlations of patient-related factors (age, weight, BMI, smoking status, presence of diabetes mellitus) with the occurrence of postoperative leaks. A total of 402 patients were included in our study. Of them, 26 (6.46%) developed PSLL. In total, 19 (73%) patients underwent percutaneous drainage and 14 patients (53.8%) were treated with intraluminal endoscopic stenting. Finally, five patients (19.2%) were treated with endoscopic clipping of the defect. Operative management was required in only one patient. There were no statistically significant differences in patient age, mean weight at the time of operation, and mean BMI. Abnormal drain amylase levels were associated with earlier detection of PSLL. More consideration needs to be given to producing a consensus regarding the management of PSLL, prioritizing nonoperative management with the combination of percutaneous drainage and endoscopic stenting as the safest and most efficient approach.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Advanced surgical options after conservative, endoscopic, or minimally invasive approaches have failed are also being performed in experienced bariatric centers. One such approach is the complex laparoscopic Roux-en-Y fistulojejunostomy formation usually performed for complex, chronic fistulas after a SG leak [ 67 ].…”

Section: Discussionmentioning

confidence: 99%