Surgical Treatment of Gastro‐Pulmonary Fistula Following Bariatric Surgery: Possible and Safe

Nun, Alon Ben; Simansky, David; Rokah, Merav; Zeitlin, Nona; Golan, Nir; Khalil, Ramez Abu; Soudack, Michalle

doi:10.1007/s00268-017-4358-z

Cited by 11 publications

(8 citation statements)

References 23 publications

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“…2 Gastrobronchial fistulas are rarely encountered after bariatric surgery (Figure 4). The reported cases occurred after an SG more so than an RYGB 2,3,6–10 and even gastric banding, 11 but never after an OABG. A gastropleural fistula, however, has been described after an OABG, 12 making it the only fistula ever encountered.…”

Section: Discussionmentioning

confidence: 91%

Management of a Gastrobronchial Fistula Presenting 5 Years After a One-Loop Gastric Bypass

et al. 2021

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Anastomotic leaks and gastric fistulas are recognized complications after sleeve gastrectomy and Roux-en-Y gastric bypass. They are, however, almost unheard of following a one-anastomosis gastric bypass. A gastrobronchial fistula, an exceedingly rare complication after bariatric surgery, has to date never been described following a one-anastomosis gastric bypass. Furthermore, there is no consensus regarding the management of this challenging complication. In our case, we present a patient who was discovered to have a gastrobronchial fistula 5 years after a one anastomosis gastric bypass. After 2 failed attempts at endoscopic stent placement, the patient was successfully managed with a laparoscopic Roux-en-Y gastrojejunostomy over the fistula.

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Section: Discussionmentioning

confidence: 91%

Management of a Gastrobronchial Fistula Presenting 5 Years After a One-Loop Gastric Bypass

et al. 2021

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“…This was highly consistent with previous studies [ 12 , 13 ]. After analyzing the reasons, we believe that hypoalbuminemia may lead to the decrease of plasma osmotic pressure, which may lead to oedema of lung tissue, further cause the occurrence of pulmonary blood circulation disorder, and finally increase the risk of pulmonary infection, and hypoalbuminemia will inhibit the synthesis of immune protein to a certain extent and then promote the decrease of immune ability of the body, which is prone to pulmonary infection [ 14 , 15 ]. Therefore, we should timely correct patients with hypoproteinemia, regulate the synthesis of immune proteins, and improve the immune function of patients, thus preventing the occurrence of pulmonary infection.…”

Section: Discussionmentioning

confidence: 99%

Study on the Risk Factors of Pulmonary Infection after Laparoscopic Surgery and Analysis of the Detection Results of Drug-Resistant Bacteria

Zhai

Zhang

Sun

et al. 2022

Journal of Healthcare Engineering

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This study aimed to investigate and analyze the risk of pulmonary infection after laparoscopic surgery and the detection results of drug-resistant bacteria. With the laparoscopic technology developing rapidly in recent years and people’s minimally invasive concept improving continuously, laparoscopic radical surgery has been widely used in the treatment of a variety of diseases. Laparoscopic surgery has the probability of causing complications. In order to avoid this, the risk factors after surgery were analyzed, and the drug-resistant bacteria were analyzed for accurate prevention and treatment. A total of 600 patients who underwent elective laparoscopic surgery in our hospital from January 2017 to September 2021 were included in the study. The risk factors and pathogen distribution of pulmonary infection were analyzed. The risk factors of pulmonary infection after laparoscopic surgery were hypoproteinemia, diabetes mellitus, pulmonary disease history, and perioperative blood transfusion. The main pathogens were Klebsiella pneumoniae, Staphylococcus aureus, Pseudomonas aeruginosa, Escherichia coli, and Streptococcus pneumoniae. In clinical work, relevant nursing intervention measures can be developed for the above factors, so as to reduce the incidence of pulmonary infection. This study finds the risk factors for pulmonary infection after surgery, and the common drug-resistant bacteria has an indicative and guiding effect on the formulation of nursing management measures.

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“…(46) The true worldwide incidence is not known, but it is probably underreported, ranging from 0.2% up to 0.37%. (10,11) Abdominal sepsis, abscesses, fistulas, and respiratory failure are some of the most common complications of a leak after SG. Most of these complications occur soon after the appearance of a leak.…”

Section: Discussionmentioning

confidence: 99%

“…The global incidence is unknown, but reported estimates range from 0.2-0.4% of all SG cases performed. (9)(10)(11) Patients typically present with a history of gastric leak and associated symptoms of abdominal pain, fever, and malaise. However, respiratory manifestations such as a persistent cough, hemoptysis, wheeze, pleuritic chest pain, or dyspnoea are common and may be the sole presenting complaint.…”

Section: Introductionmentioning

confidence: 99%

Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options

et al. 2020

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This study aimed to establish the optimal diagnostic and treatment algorithm for the management of Gastric Fistula in the Chest (GFIC) after Sleeve Gastrectomy (SG) through a systematic review of published cases. A multi-database search was performed which produced 1182 results, of which twenty-six studies were included in this systematic review. The initial presentation included subphrenic collections, leaks, or (recurrent) pneumonia with associated symptoms such as persistent cough, fever and/or dyspnoea.Computed Tomography (CT) scan in combination with either Upper Gastrointestinal series (UGI) or an Esophagogastroduodenoscopy (EGD) was used to adequately diagnose the fistulas. Initial treatment was either with clips and/or clips and stents that were placed endoscopically. When unsuccessful in majority of the cases, the surgical treatment consisted in a total gastrectomy and Roux-en-Y esophagojejunostomy in a laparoscopic or open fashion.

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Surgical Treatment of Gastro‐Pulmonary Fistula Following Bariatric Surgery: Possible and Safe

Abstract: Gastro-pulmonary fistula is a rare devastating complication of sleeve gastrectomy. When minimally invasive measures fail, there is no place for nihilism. Surgical repair is possible and safe. The data presented herein support this treatment policy.

Cited by 11 publications

References 23 publications

Management of a Gastrobronchial Fistula Presenting 5 Years After a One-Loop Gastric Bypass

Management of a Gastrobronchial Fistula Presenting 5 Years After a One-Loop Gastric Bypass

Study on the Risk Factors of Pulmonary Infection after Laparoscopic Surgery and Analysis of the Detection Results of Drug-Resistant Bacteria

Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options

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