Efficacy and Safety of Stents in the Treatment of Fistula After Bariatric Surgery: a Systematic Review and Meta-analysis
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Fistula development is a serious complication after bariatric surgery. We performed a systematic review and meta-analysis to assess the efficacy of fistula closure and complications associated with endoscopic stent treatment of fistulas, developed after bariatric surgeries, particularly Roux-en-Y gastric bypass (RYGB) and gastric sleeve (GS). Studies involving patients with fistula after RYGB or GS and those who received stent treatment only were selected. The analyzed outcomes were overall success rate of fistula closure, mean number of stents per patient, mean stent dwelling time, and procedure-associated complications. Current evidence from identified studies demonstrates that, in selected patients, endoscopic stent treatment of fistulas after GS or RYGB can be safe and effective.
KeywordsSleeve Bypass Bariatric Stent Fistula
Compliance with Ethical Standards
Conflict of Interest
The authors declare that they have no conflict of interest.
Ethical Approval Statement
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed Consent Statement
Informed consent does not apply for this study.
- 1.WHO | Obesity and overweight. Guideline: sugar intake for adults and children. http://www.who.int/mediacentre/factsheets/fs311/en/. Published 2016. Accessed 24 Oct 2016.
- 2.Garvey WT, Mechanick JI, Brett EM, Garber AJ, Hurley DL, Jastreboff AM, Nadolsky K, Pessah-Pollack R, Plodkowski R, Reviewers of the AACE/ACE Obesity Clinical Practice Guidelines American Association of Clinical Endocrinologists and American College of Endocrinology comprehensive clinical practice guidelines for medical care of patients with obesityexecutive summarycomplete guidelines available at https://www.aace.com/publications. Endocr Pract 2016;22(7):842–884. https://doi.org/10.4158/EP161356.ESGL.
- 5.American Society for Metabolic and Bariatric Surgery. Estimate of bariatric surgery numbers—American Society for Metabolic and Bariatric Surgery. www.asmbs.org. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers. Published 2014.
- 26.de Moura EGH, Orso IRB, Aurélio EF, et al. Factors associated with complications or failure of endoscopic balloon dilation of anastomotic stricture secondary to Roux-en-Y gastric bypass surgery. Surg Obes Relat Dis. 2016;12(3):582–6. https://doi.org/10.1016/j.soard.2015.11.006.CrossRefPubMedGoogle Scholar
- 34.Gonzalez J-M, Garces Duran R, Vanbiervliet G, et al. Double-type metallic stents efficacy for the management of post-operative fistulas, leakages, and perforations of the upper gastrointestinal tract. Surg Endosc. 2015;29(7):2013–8. https://doi.org/10.1007/s00464-014-3904-0.CrossRefPubMedGoogle Scholar
- 40.Kim J, Azagury D, Eisenberg D, et al. ASMBS position statement on prevention, detection, and treatment of gastrointestinal leak after gastric bypass and sleeve gastrectomy, including the roles of imaging, surgical exploration, and nonoperative management. Surg Obes Relat Dis. 2015;11(4):739–48. https://doi.org/10.1016/j.soard.2015.05.001.CrossRefPubMedGoogle Scholar
- 42.The Joanna Briggs Institute. Checklist for case series. In: Joanna Briggs Institute reviewers’ manual: 2016 edition; 2016. http://joannabriggs.org/assets/docs/critical-appraisal-tools/JBI_Critical_Appraisal-Checklist_for_Case_Series.pdf.
- 45.Podnos YD, Jimenez JC, Wilson SE, Stevens CM, Nguyen NT. Complications after laparoscopic gastric bypass. 2006;138.Google Scholar