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Chronic Leak and Fistulas

  • Luciano Antozzi
  • Priscilla Antozzi
  • Mario Norberto Antozzi
Chapter

Abstract

The worldwide acceptance of bariatric surgery is a result of its well-known results, but despite making our greatest efforts to achieve near-zero complications, some may appear. A new challenge starts when this happens, and the medical team must be prepared to manage them appropriately.

Complication management, due to its low frequency, has a learning curve hard to overcome, and it could be beneficial to centralize it in high-volume centers. Endoscopic therapies require experienced physicians, but they are less invasive and usually don’t interfere with surgical management, so, if the patient condition allows it, they should precede other major procedures like total gastrectomy, proximal gastrectomy with esophago-jejunal reconstruction, or fistulectomy with Roux-en-Y lateral anastomosis.

In this chapter we will describe the endoscopic option treatments.

Keywords

Complications Chronic leak Fistula Bariatric surgery Endoscopy 

References

  1. 1.
    Milone L, Strong V, Gagner M. Laparoscopic sleeve gastrectomy is superior to endoscopic intragastric balloon as a first stage procedure for super-obese patients (BMI > or =50). Obes Surg. 2005;15(5):612–7.CrossRefPubMedGoogle Scholar
  2. 2.
    Imaz I, Martinez-Cervell C, Garcia-Alvarez EE, Sendra-Gutierrez JM, Gonzalez-Enriquez J. Safety and effectiveness of the intragastric balloon for obesity. A meta-analysis. Obes Surg. 2008;18(7):841–6.CrossRefPubMedGoogle Scholar
  3. 3.
    Ubeda-Iglesias A, Irles-Rocamora JA, Povis-Lopez CD. Antral impaction and cardiorespiratory arrest. Complications of the intragastric balloon. Med Intensiva. 2012;36(4):315–7.CrossRefPubMedGoogle Scholar
  4. 4.
    Deviere J, Ojeda Valdes G, Cuevas Herrera L, Closset J, Le Moine O, Eisendrath P, et al. Safety, feasibility and weight loss after transoral gastroplasty: first human multicenter study. Surg Endosc. 2008;22(3):589–98.CrossRefPubMedGoogle Scholar
  5. 5.
    Moreno C, Closset J, Dugardeyn S, Barea M, Mehdi A, Collignon L, et al. Transoral gastroplasty is safe, feasible, and induces significant weight loss in morbidly obese patients: results of the second human pilot study. Endoscopy. 2008;40(5):406–13.CrossRefPubMedGoogle Scholar
  6. 6.
    Familiari P, Costamagna G, Blero D, Le Moine O, Perri V, Boskoski I, et al. Transoral gastroplasty for morbid obesity: a multicenter trial with a 1-year outcome. Gastrointest Endosc. 2011;74(6):1248–58.CrossRefPubMedGoogle Scholar
  7. 7.
    Fogel R, De Fogel J, Bonilla Y, De La Fuente R. Clinical experience of transoral suturing for an endoluminal vertical gastroplasty: 1-year follow-up in 64 patients. Gastrointest Endosc. 2008;68(1):51–8.CrossRefPubMedGoogle Scholar
  8. 8.
    Brethauer SA, Chand B, Schauer PR, Thompson CC. Transoral gastric volume reduction as intervention for weight management: 12-month follow-up of TRIM trial. Surg Obes Relat Dis. 2011;8:296.CrossRefPubMedGoogle Scholar
  9. 9.
    Schouten R, Rijs CS, Bouvy ND, Hameeteman W, Koek GH, Janssen IM, et al. A multicenter, randomized efficacy study of the EndoBarrier gastrointestinal liner for presurgical weight loss prior to bariatric surgery. Ann Surg. 2010;251(2):236–43.CrossRefPubMedGoogle Scholar
  10. 10.
    Rodriguez-Grunert L, Galvao Neto MP, Alamo M, Ramos AC, Baez PB, Tarnoff M. First human experience with endoscopically delivered and retrieved duodenal-jejunal bypass sleeve. Surg Obes Relat Dis. 2008;4(1):55–9.CrossRefPubMedGoogle Scholar
  11. 11.
    Gersin KS, Rothstein RI, Rosenthal RJ, Stefanidis D, Deal SE, Kuwada TS, et al. Open-label, sham-controlled trial of an endoscopic duodenojejunal bypass liner for preoperative weight loss in bariatric surgery candidates. Gastrointest Endosc. 2010;71(6):976–82.CrossRefPubMedGoogle Scholar
  12. 12.
    de Moura EG, Martins BC, Lopes GS, Orso IR, de Oliveira SL, Galvao Neto MP, et al. Metabolic improvements in obese type 2 diabetes subjects implanted for 1 year with an endoscopically deployed duodenal-jejunal bypass liner. Diabetes Technol Ther. 2012;14(2):183–9.CrossRefPubMedGoogle Scholar
  13. 13.
    Escalona A, Pimentel F, Sharp A, Becerra P, Slako M, Turiel D, et al. Weight loss and metabolic improvement in morbidly obese subjects implanted for 1 year with an endoscopic duodenal-jejunal bypass liner. Ann Surg. 2012;255(6):1080–5.CrossRefPubMedGoogle Scholar
  14. 14.
    Sandler BJ, Rumbaut R, Swain CP, Torres G, Morales L, Gonzales L, et al. Human experience with an endoluminal, endoscopic, gastrojejunal bypass sleeve. Surg Endosc. 2011;25(9):3028–33.CrossRefPubMedGoogle Scholar
  15. 15.
    Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2011;9(3):228–33.CrossRefPubMedGoogle Scholar
  16. 16.
    Fernandez-Esparrach G, Lautz DB, Thompson CC. Peroral endoscopic anastomotic reduction improves intractable dumping syndrome in Roux-en-Y gastric bypass patients. Surg Obes Relat Dis. 2010;6(1):36–40.CrossRefPubMedGoogle Scholar
  17. 17.
    Aly A. Argon plasma coagulation and gastric bypass – a novel solution to stomal dilation. Obes Surg. 2009;19(6):788–90.CrossRefPubMedGoogle Scholar
  18. 18.
    Galvão Neto M, Rodriguez L, Zundel N, Ayala JC, Campos J, Ramos A. Endoscopic revision of Roux-en-Y gastric bypass Stomal dilation with a suturing device: preliminary results of a first out-of-United States series. Bariatric Times. 2011;8(6):32–4.Google Scholar
  19. 19.
    Abu Dayyeh BK, Jirapinyo P, Weitzner Z, Barker C, Flicker MS, Lautz DB, et al. Endoscopic sclerotherapy for the treatment of weight regain after Roux-en-Y gastric bypass: outcomes, complications, and predictors of response in 575 procedures. Gastrointest Endosc. 2012;76(2):275–82.CrossRefPubMedPubMedCentralGoogle Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • Luciano Antozzi
    • 1
  • Priscilla Antozzi
    • 2
  • Mario Norberto Antozzi
    • 2
  1. 1.Department of Bariatric and Esophago-Gastric SurgeryHospital Italiano Regional del SurBuenos AiresArgentina
  2. 2.Department of General and Bariatric SurgeryCentro de Cirugías EspecialesBuenos AiresArgentina

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