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Closure of Gastrocutaneous Fistula Following Bariatric Surgery: a Systematic Review

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Abstract

Gastrocutaneous fistula (GCF) is a devastating complication that can arise after bariatric and metabolic surgery (BMS). This systematic review examines the success rate of closure techniques of GCF. A systematic search was conducted across MEDLINE, Embase and Cochrane databases to identify studies which reported on closure techniques of GCF after BMS in adults. Thirty-three studies (n = 108 patients) were included. Seventeen different techniques were used to close GCF across all studies. The most popular were stents (n = 17), tissue sealants (n = 12) and over-the-scope clips (n = 11). Twenty-one studies used multiple techniques to attempt closure, including endoscopic vacuum therapy and revisional surgery. This systematic review demonstrates current practice focusing on endoscopic methods such as stents and over-the-scope clips, with relative success in closing GCF.

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Data Availability

All data included in this study has been collated from articles identified through a systematic search of the literature and referenced accordingly.

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Acknowledgements

Whittington Library, Magdala Ave, London N19 5NF, provided guidance for the systematic search.

Author information

Author notes

  1. Jasmine Bawa and Liene Sulutaura have contributed equally to this work and are joint first authors.

Authors and Affiliations

  1. Department of Upper GI and Bariatric Surgery, Whittington Health NHS Trust, Magdala Ave, London, N19 5NF, UK

    Jasmine H. Bawa, Liene Sulutaura, Nikhil M. Patel, Pratik A. Sufi & Chetan Parmar

  2. Barts Health NHS Trust, London, EC1A 7BE, UK

    Chetan Parmar

  3. Apollo Hospitals Research and Education Foundation, Delhi, 50096, India

    Chetan Parmar

  4. University College London, Gower St, London, WC1E 6BT, UK

    Chetan Parmar

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  1. Jasmine H. Bawa
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  2. Liene Sulutaura
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  4. Pratik A. Sufi
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  5. Chetan Parmar
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Correspondence to Chetan Parmar.

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Key Points

• Gastrocutaneous fistula (GCF) can arise after bariatric and metabolic surgery.

• GCF can be diagnosed by endoscopy, upper GI contrast study or CT imaging.

• Supportive management comprises antibiotics, skin protection and nutrition.

• Closure techniques include stents, tissue sealants and over-the-scope clips.

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Bawa, J.H., Sulutaura, L., Patel, N.M. et al. Closure of Gastrocutaneous Fistula Following Bariatric Surgery: a Systematic Review. OBES SURG 33, 3658–3668 (2023). https://doi.org/10.1007/s11695-023-06861-3

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