Skip to main content

Advertisement

Log in

Stemming the Leak: A Novel Treatment for Gastro-Bronchial Fistula

  • DDS–SIRC COOPERATIVE CONFERENCES
  • Published:
Digestive Diseases and Sciences Aims and scope Submit manuscript

A DDS-SIRC Author Profile to this article was published on 17 October 2022

Abstract

Laparoscopic sleeve gastrectomy (LSG) is a commonly used procedure in bariatric patients that often has excellent results. Despite its advantages, LSG is burdened by specific intraoperative and postoperative early and late complications. One of the life-threatening complications is gastric fistula, usually treated with a multidisciplinary surgical–endoscopic approach. In case of failure of the latter, alternative nonoperative techniques such as the use of autologous stem cells truly represents an innovative possibility, with only few cases described in literature. Here, we report the case of a 25-year-old man with post-LSG broncho-gastric fistula treated with application of autologous stem cells after the failure of the conventional surgical/endoscopic approach.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Abbreviations

LSG:

Laparoscopic sleeve gastrectomy

GBF:

Gastro-bronchial fistula

SES:

Stricturotomy and septoplasty

RYGB:

Roux-en-Y gastric bypass

SEPS:

Self-expandable plastic stent

MSCs:

Mesenchymal stem cells

References

  1. Al Hajj G, Chemaly R. Fistula Following Laparoscopic Sleeve Gastrectomy: A Proposed Classification and Algorithm for Optimal Management. Obes Surg. 2018;28:656–664.

    Article  CAS  PubMed  Google Scholar 

  2. Campos JM, Siqueira LT, Meira MR et al. Gastrobronchial fistula as a rare complication of gastroplasty for obesity: a report of two cases. J Bras Pneumol 2007;33:475–479.

    Article  PubMed  Google Scholar 

  3. Abraham A, Virdi RP, Rajan D, et al. Gastrobronchial fistula following laparoscopic sleeve gastrectomy. BMJ Case Rep 2012 Sep 12;2012:bcr2012006789.

  4. Boru CE, Angelis F, Iossa A et al. Persistent Fistula after Sleeve Gastrectomy: A Chronic Dilemma. Chirurgia (Bucur) 2019;114:790–797.

    Article  Google Scholar 

  5. Fuks D, Dumont F, Berna P et al. Case report-complex management of a postoperative bronchogastric fistula after laparoscopic sleeve gastrectomy. Obes. Surg. 2009;19:261–264.

    Article  PubMed  Google Scholar 

  6. Alharbi SR. Gastrobronchial fistula -a rare complication post laparoscopic sleeve gastrectomy. Ann Thorac Med. 2013;8:179–180.

    Article  PubMed  PubMed Central  Google Scholar 

  7. Moeller DD, Carpenter PR. Gastrobronchial fistula: case report and review of the English literature. Am J Gastroenterol. 1985;80:538–541.

    CAS  PubMed  Google Scholar 

  8. Miwa K, Takamori S, Hayashi A et al. Gastrobronchial fistula after esophagectomy. Eur J Cardiothorac Surg. 2004;25:460.

    Article  PubMed  Google Scholar 

  9. Gaensler EH, Jeffrey RB Jr, Noonan CD. Gastrobronchial fistula: an unusual complication of Nissen fundoplication. Gastrointest Radiol. 1988;13:6–8.

    Article  CAS  PubMed  Google Scholar 

  10. Jeganathan R, Pore N, Clements WD et al. Gastrobronchial fistula—a complication of splenectomy. Ulster Med J. 2004;73:126–128.

    CAS  PubMed  PubMed Central  Google Scholar 

  11. Guillaud A, Moszkowicz D, Nedelcu M et al. Gastrobronchial fistula: a serious complication of sleeve gastrectomy. Results of a French multicentric study. Obes Surg. 2015;25:2352–2359.

    Article  PubMed  Google Scholar 

  12. De Dominicis F, Dhahri A, Verhaeghe P et al. Treatment of a chronic fistula after sleeve gastrectomy by a Roux-en-Y limb. J Visc Surg 2010;147:71–74.

    Google Scholar 

  13. Rebibo L, Dhahri A, Berna P et al. Management of gastrobronchial fistula after laparoscopic sleeve gastrectomy. Surg. Obes. Relat. Dis. 2009;19:261–264.

    Google Scholar 

  14. Campos JM, Franca Pereira E, Evangelista L et al. Gastrobronchial fistula after sleeve gastrectomy and gastric bypass: endoscopic management and prevention. Obes Surg. 2011;21:1520–1529.

    Article  PubMed  Google Scholar 

  15. Saliba C, Nicolas G, Diab S et al. Gastrobronchial fistula following a laparoscopic sleeve gastrectomy. Am J Case Rep. 2019;20:31–35.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Sabawi M, Alhasson A, Abualruz AR et al. Gastrobronchial fistula: a rare complication of postlaparascopic sleeve gastrectomy—a case report and literature review. Case Rep Radiol. 2021;2021:6641319.

    PubMed  PubMed Central  Google Scholar 

  17. Greilsamer T, Mahe PJ, Blanchard C et al. Late gastrobronchial fistula postsleeve gastrectomy. Surg Obes Relat Dis. 2017;13:1088.

    Article  PubMed  Google Scholar 

  18. Sakran N, Assalia A, Keidar A et al. Gastrobronchial fistula as a complication of bariatric surgery: a series of 6 cases. Obes Facts. 2012;5:538–545.

    Article  PubMed  Google Scholar 

  19. Albanopoulos K, Tsamis D, Leandros E et al. Gastrobronchial fistula as a late complication of sleeve gastrectomy. Surg Obes Relat Dis. 2013;9:e97–e99.

    Article  PubMed  Google Scholar 

  20. Marie L, Robert M, Montana L et al. A French National Study on Gastropleural and Gastrobronchial Fistulas After Bariatric Surgery: The Impact of Therapeutic Strategy on Healing. Obes Surg. 2020;30:3111–3118.

    Article  CAS  PubMed  Google Scholar 

  21. Al-Lehibi A. Endoscopic Management of Gastrobronchial Fistula after Laparoscopic Sleeve Gastrectomy: A Case Report. Saudi J Med Med Sci 2019;7:106–109.

    Article  PubMed  PubMed Central  Google Scholar 

  22. Ben Nun A, Simansky D, Rokah M et al. Surgical Treatment of Gastro-Pulmonary Fistula Following Bariatric Surgery: Possible and Safe. World J Surg. 2018;42:1792–1797.

    Article  PubMed  Google Scholar 

  23. Guerrero-Silva LA, López-García S, Guardado- Bermúdez F, et al. Fístula Gastrobronquial: Complicación Mayor De Manga Gástrica. Cir Cir. 2015;83: 46–50 [Article in Spanish].

  24. Barboza Besada E, Barboza Beraùn A, Castillo-àngeles M et al. Gastrobronchial fistula post sleeve gastrectomy. Rev Gastroenterol Peru 2013;33:157–161.

    PubMed  Google Scholar 

  25. Badia-Closa J, Luna A, Montmany S et al. Esogastro-Pleuro-Bronchial Fistula: an Unusual Complication After Sleeve Gastrectomy. Obes Surg. 2020;30:4122–4123.

    Article  PubMed  Google Scholar 

  26. Cuadrado Ayuso M, Franco Herrera R, Lago Oliver J et al. Successful management of laparoscopic sleeve gastrectomy leak with negative pressure therapy. Obes. Surg. 2017;27:2452–2453.

    Article  PubMed  Google Scholar 

  27. Leeds SG, Burdick JS. Management of gastric leaks after sleeve gastrectomy with endoluminal vacuum (E-Vac) therapy. Surg. Obes. Relat. Dis. 2016;12:1278–1285.

    Article  PubMed  Google Scholar 

  28. Devbhandari MP, Jain R, Galloway S et al. Benign gastro-bronchial fistula –an uncommon complication of esophagectomy: case report. BMC Surg 2005;5:16.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Wankhade D, Shen M, Kolhe R et al. Review Article Advances in Adipose-Derived Stem Cells Isolation, Characterization, And Application in Regenerative Tissue Engineering. Stem Cells Int. 2016;2016:3206807.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Spinelli MG, Lorusso V, Palmisano F et al. Endoscopic repair of a vescicouterine fistula with the injection of microfragmented autologous adipose tissue (Lipogems®). Turk J Urol. 2020;46:398–402.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Tremolada C, Ricordi C, Caplan AI et al. Mesenchymal Stem Cells in Lipogems, a Reverse Story: from Clinical Practice to Basic Science. Methods Mol Biol. 2016;1416:109–122.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgments

We wish to thank Ms. Elena Baldissone for the English editing and the drawing.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to F. M. Mongardini.

Ethics declarations

Conflict of interest

The authors have no conflicts of interest to declare regarding this case presentation.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

A profile of Federico Maria Mongardini is available at https://doi.org/10.1007/s10620-022-07712-4.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Mongardini, F.M., Cacciatore, C., Catauro, A. et al. Stemming the Leak: A Novel Treatment for Gastro-Bronchial Fistula. Dig Dis Sci 67, 5425–5432 (2022). https://doi.org/10.1007/s10620-022-07711-5

Download citation

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10620-022-07711-5

Keywords

Navigation