Total gastrectomy for failed treatment with endotherapy of chronic gastrocutaneous fistula after sleeve gastrectomy

Endoscopic Biological Glue Injection for Treating Multiple Staple-Line Leaks and Dehiscence Following Laparoscopic Sleeve Gastrectomy – A Case Report and Review of the Literature

“…Vol.4 No.S1:001 controlled, further treatment may include each of the following approaches, which may be utilized primarily in hemodynamically stable patients with contained leaks i.e., 1) Conservative treatment including nothing per-os (NPO), antibiotics, and possibly TPN with expectant management until spontaneous closure of the fistula occurs; 2) Stent placement allowing sleeve decompression and fistula-closure; 3) Endoscopic closure procedures utilizing clips, suturing or biocompatible glues; 4) Endoscopic intra-luminal drainage; 5) Placement of a T-tube gastrostomy; and finally, 6) Reconstitution into a RYGB or performing another surgical interventions [7,13,[19][20][21][22]. The last option is relevant especially in chronic leaks where other treatments failed.…”

Salvage procedures for chronic gastric leaks after sleeve gastrectomy: the role of laparoscopic Roux-en-Y fistulo-jejunostomy

“…However, leaving the fistula tract in very high localization and additional stomach transection close to the inflamed fistula tract remain serious limitations of the approach. Total gastrectomy may treat the problem (11,12), but must be avoided as a first option because of subsequent cumbersome nutritional consequences and relatively high risk of complications related to the oesophago-jejunal anastomosis.…”

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

“…There are 3 surgical options: conversion into a LRYGB [12,13], a Roux-limb placement [12][13][14][15][16][17], or resection surgery (total gastrectomy with an esojejunostomy) [3,12]. The first 2 options have proven their feasibility and efficacy (short series), but an open total gastrectomy is sometimes required in challenging situations (inflammation, fibrosis, dissection, adhesions) [12][13][14][15][16][17][18].…”