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Obesity Surgery

, Volume 25, Issue 7, pp 1258–1260 | Cite as

Outcome of Leaks After Sleeve Gastrectomy Based on a New Algorithm Addressing Leak Size and Gastric Stenosis

  • Gianfranco DonatelliEmail author
  • Jean-Marc Catheline
  • Jean-Loup Dumont
  • Bertrand Marie Vergeau
  • Thierry Tuszynski
  • Fabrizio Cereatti
  • Fausto Fiocca
  • Bruno Meduri
Letter to the Editor

Text

We welcomed with great interest the masterpiece of Nedelcu et al. [1] concerning the outcome of leaks after laparoscopic sleeve gastrectomy (LSG) based on a new algorithm addressing leak size and gastric stenosis. The article stressed the importance of adopting this new algorithm in order to standardize leak management, thus reducing the number of endoscopic procedures. We agree with the authors about the use of endoscopic internal drainage (EID) by means of double pigtail to achieve complete healing. As already reported by our team [2], since March 2013, we adopted EID as the only endoscopic treatment in case of fistulas after LSG or gastric bypass, irrespective to leak size.

Moreover, we believe in the importance of introducing a well-defined algorithm in order to standardize the endoscopic treatment modality for leak following bariatric surgery.

However, according to our experience, we have some remarks to do. Here, we report a case of a 59-year-old woman, presenting an early...

Keywords

Bariatric Surgery Laparoscopic Sleeve Gastrectomy Fistula Defect Double Pigtail Large Orifice 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflict of Interest

The authors declare that they have no competing interests.

Supplementary material

Video 1

Endoscopic exploration of cardial zone showing no fistula and complete re-epithelialization of a 2 cm staple line dehiscence (MOV 10037 kb)

References

  1. 1.
    Nedelcu M, Manus T, Cotirlet A et al., Outcome Of Leaks After Sleeve Gastrectomy Based On A New Algorithm Adressing Leak Size And Gastric Stenosis. ObesSurgDOI  10.1007/s11695-014-1561-y
  2. 2.
    Donatelli G, Ferretti S, Vergeau BM, et al. Endoscopic Internal drainage with enteral nutrition (EDEN) for treatment of leaks following sleeve gastrectomy. ObesSurg. 2014;24:1400–07.Google Scholar
  3. 3.
    Rosenthal RJ. International Sleeve Gastrectomy Expert Panel Consensus statement: best practice guidelines based on experience of >12000 cases. SOARD. 2012;8:8–19.Google Scholar
  4. 4.
    Alcaide N, Vargas-Garcia AL, Serna-Higuera C, et al. EUS-guided drainage of liver abscess by using a lumen-apposing metal stent (with video). GIE. 2013;78(6):941–2.Google Scholar

Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Gianfranco Donatelli
    • 1
    • 2
    Email author
  • Jean-Marc Catheline
    • 3
  • Jean-Loup Dumont
    • 1
  • Bertrand Marie Vergeau
    • 1
  • Thierry Tuszynski
    • 1
  • Fabrizio Cereatti
    • 2
  • Fausto Fiocca
    • 2
  • Bruno Meduri
    • 1
  1. 1.Unité d’Endoscopie InterventionnelleHôpital Privé des Peupliers, Générale de SantéParisFrance
  2. 2.Unit of Interventional Endoscopy, Department of General Surgery “P. Stefanini”“Sapienza” University of RomeRomeItaly
  3. 3.Service de Chirurgie ViscéraleCentre Hôspitalier de Saint-DenisSaint-DenisFrance

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