Persistent gastric fistula after sleeve gastrectomy: an analysis of the time between discovery and reoperation

Cost-effectiveness analysis of stent type in endoscopic treatment of gastric leak after laparoscopic sleeve gastrectomy

“…Previous studies have shown an advantage of a DPS after sleeve gastrectomy in terms of duration of hospital stay and time to cure. Most gastric leaks after sleeve gastrectomy require stenting to achieve healing, although alternative treatments have been described.…”

Open total gastrectomy with Roux-en-Y reconstruction for a chronic fistula after sleeve gastrectomy

“…Malnutrition occurs in many complicated obese patients [13,20,26], and our experience shows that nutritional status was unrelated to weight or changes in BMI. In the present study, enteral nutrition was used for all patients to achieve a preoperative albumin level of 30 g/L; definitive surgical treatment should be delayed until the patient has been nutritionally optimized [20].…”

“…A delay of 3 to 4 months [8,11,26] (and not 12 mo) after unsuccessful initial interventional management appears to decrease the incidence of gastric leak-related complications [26] and the rate of resective surgery in our department ( T4 Table 4). Moreover, another important message could be inferred from Table 4: with increased experience for surgical treatment of chronic leak after sleeve, the approach is less invasive (more fistulojejunostomy than total gastrectomy) and more frequently performed by laparoscopy.…”

“…Moreover, another important message could be inferred from Table 4: with increased experience for surgical treatment of chronic leak after sleeve, the approach is less invasive (more fistulojejunostomy than total gastrectomy) and more frequently performed by laparoscopy. In our opinion, conservative approaches and laparoscopy must be considered for each patient, but our experience and the evidence from the literature [12,15,17,26] have found that they should be reserved for selected patients at an early period. When these procedures are technically impossible, the present study found that a salvage total gastrectomy can be performed safely.…”

Gastric fistula secondary to drainage tube penetration: A report of a rare case

“…The majority of gastric fistula cases may be treated by conservative therapy, including the administration of drugs such as somatostatin, antibiotics and supportive care (5). Certain cases may be treated using the injection of fibrin sealant (6), however, surgery should be performed in cases that have persisted for 120 days following diagnosis (7). Generally, patient outcome is good in patients with gastric fistula due to the administration of timely therapy (8).…”