Tu1394 Efficacy of Endoscopic Treatment of Symptomatic Upper Gastrointestinal Leaks and Fistulas Post-Bariatric Surgery: Report of 25 Cases

Ghotb, Alireza; Shah, Janak N.; Binmoeller, Kenneth F.; Weilert, Frank; Bhat, Yasser M.

doi:10.1016/j.gie.2011.03.886

Cited by 1 publication

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“…Multimo- dality endoscopic therapy included injection [fibrin glue or cyanoacrylate], endoprosthesis (fully covered plastic or metal stents), endoclips and T-tag placement were used. Healing rate doesn't depend on type of surgery or fistula size at presentation and no complications were reported [23].…”

Section: Discussionmentioning

confidence: 91%

Case Report: Endoscopic Management of Sleeve Gastrectomy Fistula

Roşu

Ferreira

Ribeiro

et al. 2016

Acta Medica Marisiensis

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Background. Morbid obesity is an important cause of morbidity and mortality. Bariatric surgery is the best option to manage obesity. Vertical gastrectomy is safe and effective but sometimes complicate with hemorrhage, fistulas and stenosis. Fistulas can be solved by conventional surgery or interventional endoscopy. Case presentation. We describe a morbidly obese patient with vertical gastrectomy who developed complications after surgery. Immediately after surgery the patient developed sepsis. Upper gastrointestinal endoscopy excluded fistula. One month later a peri-gastric abscess developed due to a fistula orifice in the distal esophagus, treated with argon plasma and two double pigtail plastic stents placed endoscopically to drain the abscess. The stents were removed two weeks later and was placed a covered metallic stent in the distal esophagus. Six weeks later the metallic stent was removed and the orifice closed. Four months later the patient developed sepsis. Computer tomography revealed a subdiaphragmatic abscess and endoscopy revealed a 2 mm fistula orifice at the previous site, treated with argon plasma and two troughthe-scope clips that closed it. There were no further incidents after two years of follow-up. Conclusions. Early diagnosis and endoscopic approach can resolve these complications without the morbidity and increased mortality risk of surgical re-interventions.

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Section: Discussionmentioning

confidence: 91%