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>Journals >Cirujano General >Year 2016, Issue 3


Romero MC, Paipilla MO
Fistula after laparoscopic sleeve gastrectomy
Cir Gen 2016; 38 (3)

Language: Español
References: 21
Page: 158-161
PDF: 4. Kb.


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ABSTRACT

We present four patients with gastric leak after sleeve gastrectomy for the treatment of morbid obesity. All of them came from another hospital and were admitted an average of 10 days after surgery. The perforation was located at the esophagogastric junction and measured two centimeters. Every patient was operated upon four times, with a hospital stay of 20 days. Three patients closed the fistula and one requested his transfer to another hospital in Mexico City. We review a clinical-therapeutic classification for the management of these lesions and attempt to explain the mechanisms of production and the way to treat them. Lesions are classified in three categories: early, intermediate and late. All of our patients had late leaks. The nature of the lesion was described as thermal tissue damage, the creation of a high-pressure tube adjacent to two sphincters and the empirical use of different sizes of staples. Finally, we review the new forms of treatment for late post sleeve gastrectomy leaks.


Key words: Laparoscopic sleeve gastrectomy, leaks after sleeve gastrectomy, late fistula after sleeve gastrectomy.


REFERENCIAS

  1. Chu CA, Gagner M, Quinn T, et al. Two-stage laparoscopic biliopancreatic diversion with duodenal switch: an alternative approach to super-super morbid obesity (abstract). Surg Endosc. 2002; 16: S069.

  2. Eid GM, Brethauer S, Mattar SG, Titcher RL, Gourash W, Schauer PR. Laparoscopic sleeve gastrectomy for super obese patients: forty-eigth percent excess weigth loss after 6 to 8 years with 93% follow-up. Ann Surg. 2012; 256: 262-265.

  3. Yehoshua RT, Eidelman LA, Stein M, Fichman S, Mazor A, Chen J, et al. Laparoscopic sleeve gastrectomy, volume and pressure assessment. Obes Surg. 2008; 18: 1083-1038.

  4. Menenakos E, Konstantinos MS, Albanopoulos K, Papailiou J, Teodorou D, Leandros E. Laparoscopic sleeve gastrectomy performed with intent to treat morbid obesity: a prospective single-center study of 261 patients with a median follow up of 1 year. Obes Surg. 2010; 20: 276-282.

  5. Burgos AM, Braghetto I, Cscendes A, Maluenda F, Korn O, Yarmuch J, et al. Gastric leak after laparoscopic-sleeve gastrectomy for obesity. Obes Surg. 2009; 19: 1672-1677.

  6. Serra C, Baltasar A, Andero L, Pérez N, Bou R, Bengochea M, et al. Treatment of gastric leaks with self expanding stents after sleeve gastrectomy. Obes Surg. 2007; 17: 866-872.

  7. Kauer WK, Stein HJ, Dittler HJ, Siewert JR. Stent implantation as a treatment option in patients with thoracic anastomotic leaks after esophagectomy. Surg Endosc. 2008; 22: 50-53.

  8. Sporn E, Miedema BW, Astudillo JA, Thaler K. Lessons learned establishing an animal model for endoscopic stent placement to treat gastroyeyunal anastomotic leaks after gastric bypass. Obes Surg. 2009; 19: 1163-1169.

  9. Lindenmann J, Matzi V, Porubsky C, Anneg U, Sankin O, Gabor S, et al. Self-expandable covered metal tracheal type stent for sealing cervical anastomotic leak after esophagectomy and gastric pull-up: pitfalls and posibilities. Ann Thorac Surg. 2008; 85: 354-356.

  10. Ramos AC, Ramos MG, Campos JM, Galvao Neto M dos P, Bastos EL. Laparoscopic total gastrectomy as an alternative treatment to postsleeve chronic fistula. Surg Obes Relat Dis. 2015; 11: 552-556.

  11. Huerta S, DeShields S, Shiner R, Li Z, Liu C, Sawicki M, et al. Safety and efficacy of postoperative continuous positive airway pressure to prevent pulmonary complications after Roux-en-Y gastric bypass. J Gastrointest Surg. 2002; 6: 354-358.

  12. Youssef T, Abdalla E, El-Alfly K, Dawoud I, Morshed M, Farid M. Impact of botulinium neurotoxin pyloric injection during laparoscopic sleeve gastrectomy on postoperative gastric leak: a clinical randomized study. Obes Surg. 2016; 26: 494-504.

  13. Braghetto I, Davanzo C, Korn O, Csendes A, Valladares H, Herrera E, et al. Scintigraphic evaluation of gastric emptying on obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009; 19: 1515-1521.

  14. Tan JT, Kariyawasam S, Wijeratne T, Chandraratna HS. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010; 20: 403-440.

  15. Soufron J. Leak or fistula after sleeve gastrectomy, treatment with Pigtail drain by the Rendezvous Technique. Obes Surg. 2015; 25: 1979-1980.

  16. Shehab HM, Hakky SM, Gawdat KA. An endoscopic strategy combining mega stents and over the scope clips for the management of postbariatric surgery leaks and fistulas (with video). Obes Surg. 2016; 26: 941-948.

  17. Arteaga-González I, Martín-Malagón A, Martin-Pérez J, Carrillo-Pallarés A. Ulsefulness of clinical signs and diagnostic test for suspected leaks in bariatric surgery. Obes Surg. 2015; 25: 1680-1684.

  18. ASMBS guideline on the prevention and detection of gastrointestinal leak after gastric bypass including the role of imaging and surgical exploration. Surg Obes Relat Dis. 2009; 5: 293-296.

  19. Hussain A, El-Hasani S. Diagnostic laparoscopy or CT Scan to diagnose the leak following Bariatric Surgery. Obes Surg. 2016; 26: 617-618.

  20. Van de Vrande S, Himpens J, El Mourad H, Debaerdemaeker R, Leman G. Management of chronic proximal fistulas after sleeve gastrectomy by laparoscopic Roux-limb placement. Surg Obes Relat Dis. 2013; 9: 856-861.

  21. Nedelcu M, Skalli M, Deneve E, Fabre J, Nocca D. Surgical management of chronic fistula after sleeve gastrectomy. Surg Obes Relat Dis. 2013; 9: 879-884.






>Journals >Cirujano General >Year 2016, Issue 3
 

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