Emergencies After Bariatric Surgery: The Role of Flexible Endoscopy and Interventional Radiology
Nowadays bariatric surgery is the most valid and safe method to treat severe cases of obesity that are refractory to the conventional restrictive dietary approaches. However, along with the increasing number of procedures performed, the incidence of post-bariatric surgery complications is also rising. The clinical and radiological work-up is difficult and variable, and treatment is both laparoscopic and endoscopic, with better efficacy and faster recovery with endoscopy. Unfortunately, there is still no clear evidence or guidelines that can help the physicians and surgeons to solve and manage the high rates of morbidity and mortality. In this chapter, the authors illustrate the most commonly adopted endoscopic and radiologic approaches and propose a therapeutic algorithm for post-bariatric surgical complications.
KeywordsPost-bariatric complications Bleeding Anastomotic leak Endoscopic therapy Stenting Internal drainage Endoluminal suture Over-the-scope clips
The “drain” technique in a leak following a mini-gastric by-pass. Through placement of pigtail plastic stents, endoscopic internal drainage allows direct reabsorption of the wall and adjacent collection (MP4 126609 kb)
A post-LSG leak successfully treated with a combination therapy. After visualization of the wall defect, the endoluminal suturing system permits “closing” and the FCSEMS avoids the recurrent contact damage, providing better local conditions for a faster and solid healing (MP4 266849 kb)
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