Endotherapy including temporary stenting of fistulas of the upper gastrointestinal tract after laparoscopic bariatric surgery

• DOI: 10.1055/s-2007-966533
• Publication Date: 2007-07-05T09:32:36Z
• Authors: P. Eisendrath; M. Cremer; J. Himpens; G.-B. Cadière; O. Le Moine; J. Devière
• Keywords: Sleeve gastrectomy; Biliopancreatic Diversion; Duodenal switch

Reoperations for complications of bariatric surgery are associated with high morbidity and mortality. It is not known whether endoscopic treatment may reduce reoperation rates.Twenty-one patients underwent persisting large anastomotic leaks before considering redo surgery. Eight had a gastric bypass, eight sleeve gastrectomy combined duodenal switch (SDS), four alone, one Scopinaro procedure (biliopancreatic diversion). Fistulas were gastrocutaneous in 15 patients, duodenocutaneous 2, gastroperitoneal 3, gastrobronchial 1. Partially covered self-expanding metal stents (SEMSs) used, followed by additional procedures if the SEMS failed. SEMSs removed traction alone or insertion plastic stent (SEPS) extraction both together.SEMS led to 62 % (13/21) primary closures. Complementary 4 secondary Total success rate was 81 (17/21). Three whom failed but died during postoperative follow-up; patient from pulmonary embolism extraction. The rates endotherapy 100 (8/8) bypass group, 62.5 (5/8) SDS 75 (3/4) (1/1) procedure. Gastrocutaneous fistulas on sutures successfully treated 60 cases (6/10), while other (11/11) ( P = 0.0351).Endoscopic using feasible. Healing severe obtained (17/21) avoiding high-risk reintervention. suture most difficult condition treat.