Abstract
Introduction
Proximal gastric leak is one of the most common complications after laparoscopic sleeve gastrectomy (LSG). Endoscopy is the gold standard treatment for acute staple-line leaks. Surgery is the most effective treatment modality in case of chronic fistula.
Material and Methods
A 55-year- old man presented an acute leak after LSG. The leak was treated with metal stent deployment with temporary closure. After 6 months, he presented leak recurrence with general sepsis, perigastric-infected collection, and gastro-jejunal fistula.
Results
Endoscopic internal drainage (EID) was performed; however, due to fistula persistence, a surgical procedure was proposed. The patient refused revisional surgery; therefore, endoscopic salvage procedure was decided. A fully covered metal stent was deployed in order to bypass the perigastric collection creating an endoscopic gastro-jejunal anastomosis.
Conclusion
Revisional surgery is the gold standard treatment for chronic fistula after SG. Endoscopic treatment with SEMS deployment may be a sound option in selected cases especially after failure of other endoscopic techniques or refusal of revisional surgery.
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This study is in accordance with the ethical standards as laid down in the 1964 Declaration of Helsinki and its later amendments or comparable ethical standards.
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The authors declare that they have no conflict of interest.
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Informed consent was obtained from all individual participants included in the study.
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Donatelli, G., Guerriero, L., Cereatti, F. et al. Endoscopic Fistula-jejunostomy for Chronic Gastro-jejunal Fistula After Sleeve Gastrectomy. OBES SURG 28, 1456–1457 (2018). https://doi.org/10.1007/s11695-018-3193-0
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DOI: https://doi.org/10.1007/s11695-018-3193-0