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Gastrogastric Fistulae Following Gastric Bypass Surgery—Clinical Recognition and Treatment

  • Stomach and Duodenum (J Pisegna, Section Editor)
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Abstract

Gastrogastric fistula (GGF) formation is an uncommon but well-recognized complication following Roux-en-Y gastric bypass for morbid obesity. Patients with GGF may be asymptomatic or have nonspecific problems of abdominal pain, weight regain, or ulcer formation at the gastrojejunal anastomosis. Maintaining a high index of suspicion is the key to diagnosis. Flexible upper endoscopy and upper gastrointestinal fluoroscopy are complementary imaging modalities for securing the diagnosis of GGF. Surgical repair of GGF is generally the most definitive management but is invasive and has the potential for morbidity. Endoscopic methods of closure have gained favor in recent years due to their noninvasive nature despite the lack of long-term data regarding their success. Novel methods of endoscopic closure, including endoscopic suturing, more closely resemble the surgical paradigm and will likely supplant traditional surgical methods for the management of GGF.

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Conflict of Interest

Eric M. Pauli, Hiba Beshir, and Abraham Mathew declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with animal subjects performed by any of the authors. With regard to the authors’ research cited in this paper, all procedures were followed in accordance with the ethical standards of the responsible committee on human experimentation and with the Helsinki Declaration of 1975, as revised in 2000 and 2008.

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Authors and Affiliations

  1. Division of Minimally Invasive and Bariatric Surgery, Department of Surgery, Penn State Hershey Medical Center, 500 University Drive, MC HU33, Hershey, PA, 17033, USA

    Eric M. Pauli

  2. Division of Gastroenterology and Hepatology, Department of Medicine, Penn State Hershey Medical Center, 500 University Drive, MC HU33, Hershey, PA, 17033, USA

    Hiba Beshir & Abraham Mathew

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  1. Eric M. Pauli
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  2. Hiba Beshir
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Correspondence to Abraham Mathew.

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This article is part of the Topical Collection on Stomach and Duodenum

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Pauli, E.M., Beshir, H. & Mathew, A. Gastrogastric Fistulae Following Gastric Bypass Surgery—Clinical Recognition and Treatment. Curr Gastroenterol Rep 16, 405 (2014). https://doi.org/10.1007/s11894-014-0405-1

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