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Comprehensive Endoluminal Treatment of Sleeve Gastrectomy Complications

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Endoscopy in Obesity Management

Abstract

The prevalence of laparoscopic vertical sleeve gastrectomy (LSG) for the treatment of morbid obesity has increased markedly over the last decade, and now surpasses gastric bypass surgery in the United States. LSG is a widely accepted operation that has been proven to be safe and effective as a stand-alone primary weight loss procedure. Nevertheless, LSG has its own set of unique complications. Bleeding, leaks, stenosis, and fistula are possible complications, albeit with an overall low incidence. Stenosis and leaks are the more common major complications and have a peculiar onset, requiring specific actions. Endoscopy plays a major role in treating both of these complications, and this chapter will present a comprehensive and stepwise method in showing how endoluminal approaches can be successful.

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References

  1. Angrisani L, Santonicola A, Iovino P, Formisano G, Buchwald H, Scopinaro N. Bariatric surgery worldwide 2013. Obes Surg. 2015;25(10):1822–32.

    Article  CAS  PubMed  Google Scholar 

  2. Zellmer JD, Mathiason MA, Kallies KJ, Kothari SN. Is laparoscopic sleeve gastrectomy a lower risk bariatric procedure compared with laparoscopic Roux-en-Y gastric bypass? A meta-analysis. Am J Surg. 2014;208(6):903–10; discussion 909–10.

    Article  PubMed  Google Scholar 

  3. Villalonga R, Himpens J, Van de Vrande S. Laparoscopic management of persistent stricture after laparoscopic sleeve gastrectomy. Obes Surg. 2013;23(10):1655–61.

    Article  Google Scholar 

  4. Rosenthal RJ, International Sleeve Gastrectomy Expert Panel, Diaz AA, Arvidsson D, Baker RS, Basso N, et al. International sleeve Gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.

    Google Scholar 

  5. Burgos AM, Csendes A, Braghetto I. Gastric stenosis after laparoscopic sleeve gastrectomy in morbidly obese patients. Obes Surg. 2013;23(9):1481–6.

    Article  PubMed  Google Scholar 

  6. Shnell M, Fishman S, Eldar S, Goitein D, Santo E. Balloon dilatation for symptomatic gastric sleeve stricture. Gastrointest Endosc. 2014;79(3):521–4.

    Article  PubMed  Google Scholar 

  7. Zundel N, Hernandez JD, Galvao Neto M, Campos J. Strictures after laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(3):154–8.

    Article  PubMed  Google Scholar 

  8. Ogra R, Kini GP. Evolving endoscopic management options for symptomatic stenosis post-laparoscopic sleeve gastrectomy for morbid obesity: experience at a large bariatric surgery unit in New Zealand. Obes Surg. 2015;25(2):242–8.

    Article  PubMed  Google Scholar 

  9. Donatelli G, Dumont JL, Pourcher G, Tranchart H, Tuszynski T, Dagher I, et al. Pneumatic dilation for functional helix stenosis followings sleeve gastrectomy: long-term follow-up (with videos). Surg Obes Relat Dis. 2016;13(6):943–50. doi:10.1016/j.soard.2016.09.023.

    Article  PubMed  Google Scholar 

  10. Campos JM, Pereira EF, Evangelista LF, Siqueira L, Neto MG, Dib V, et al. Gastrobronchial fistula after sleeve gastrectomy and gastric bypass: endoscopic management and prevention. Obes Surg. 2011;21(10):1520–9.

    Article  PubMed  Google Scholar 

  11. Silva LB, Moon RC, Teixeira AF, Jawad MA, Ferraz ÁA, Neto MG, et al. Gastrobronchial fistula in sleeve gastrectomy and Roux-en-Y gastric bypass: a systematic review. Obes Surg. 2015;25(10):1959–65.

    Article  PubMed  Google Scholar 

  12. Puli SR, Spofford IS, Thompson CC. Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis. Gastrointest Endosc. 2012;75(2):287–93.

    Article  PubMed  Google Scholar 

  13. Basha J, Appasani S, Sinha SK, et al. Mega stents: a new option for management of leaks following laparoscopic sleeve gastrectomy. Endoscopy. 2014;46(Suppl 1):E49–50.

    PubMed  Google Scholar 

  14. Shehab HM, Hakky SM, Gawdat KA. An endoscopic strategy combining mega stents and over-the-scope clips for the management of post-bariatric surgery leaks and fistulas (with video). Obes Surg. 2016;26(5):941–8.

    Article  PubMed  Google Scholar 

  15. Fischer A, Bausch D, Richter-Schrag HJ. Use of a specially designed partially covered self-expandable metal stent (PSEMS) with a 40-mm diameter for the treatment of upper gastrointestinal suture or staple line leaks in 11 cases. Surg Endosc. 2013;27(2):642–7.

    Article  PubMed  Google Scholar 

  16. Nedelcu M, Manos T, Cotirlet A, Noel P, Gagner M. Outcome of leaks after sleeve gastrectomy based on a new algorithm addressing leak size and gastric stenosis. Obes Surg. 2015;25(3):559–63.

    Article  PubMed  Google Scholar 

  17. Van Wezenbeek MR, de Milliano MM, Nienhuijs SW, Friederich P, Gillissen LP. A specifically designed stent for anastomotic leaks after bariatric surgery: experiences in a tertiary referral hospital. Obes Surg. 2016;26(8):1875–80.

    Article  PubMed  Google Scholar 

  18. Fishman MB, Sedov VM, Lantsberg L, et al. Vestn Khir Im I I Grek. 2008;167(1):29–32. (Article in Russian).

    CAS  PubMed  Google Scholar 

  19. Galloro G, Magno L, Musella M, Manta R, Zullo A, Forestieri P. A novel dedicated endoscopic stent for staple-line leaks after laparoscopic sleeve gastrectomy: a case series. Surg Obes Relat Dis. 2014;10(4):607–11.

    Article  PubMed  Google Scholar 

  20. Galvao Neto M, Silva L, Quadros LG, de Souza G, MD RA, Ferraz AB, Campos J. Sleeve gastrectomy leak: endoscopic management through customized bariatric stent (A5028). Surg Obes Relat Dis. 2016;27(7 Suppl):S74–5.

    Article  Google Scholar 

  21. Pequignot A, Fuks D, Verhaeghe P, Dhahri A, Brehant O, Bartoli E, et al. Is there a place for pigtail drains in the management of gastric leaks after laparoscopic sleeve gastrectomy? Obes Surg. 2012;22(5):712–20.

    Article  CAS  PubMed  Google Scholar 

  22. Caballero Y, López-Tomassetti E, Castellot A, Hernández JR. Endoscopic management of a gastric leak after laparoscopic sleeve gastrectomy using the over-the-scope-clip (Ovesco) system. Rev Esp Enferm Dig. 2016;108(11):746–50.

    PubMed  Google Scholar 

  23. Keren D, Eyal O, Sroka G, Rainis T, Raziel A, Sakran N, et al. Over-the-scope clip (OTSC) system for sleeve gastrectomy leaks. Obes Surg. 2015;25(8):1358–63.

    Article  CAS  PubMed  Google Scholar 

  24. Seyfried F, Reimer S, Miras AD, Kenn W, Germer CT, Scheurlen M, Jurowich C. Successful treatment of a gastric leak after bariatric surgery using endoluminal vacuum therapy. Endoscopy. 2013;45(Suppl 2):E267–8.

    PubMed  Google Scholar 

  25. Hwang JJ, Jeong YS, Park YS, Yoon H, Shin CM, Kim N, Lee DH. Comparison of endoscopic vacuum therapy and endoscopic stent implantation with self-expandable metal stent in treating postsurgical gastroesophageal leakage. Medicine (Baltimore). 2016;95(16):e3416.

    Article  CAS  Google Scholar 

  26. Campos JM, Ferreira FC, Teixeira AF, Lima JS, Moon RC, D'Assunção MA, Neto MG. Septotomy and balloon dilation to treat chronic leak after sleeve gastrectomy: technical principles. Obes Surg. 2016;26(8):1992–3.

    Article  PubMed  Google Scholar 

  27. Mahadev S, Kumbhari V, Campos JM, Galvao Neto M, Khashab MA, Chavez YH, et al. Endoscopic septotomy: an effective approach for internal drainage of sleeve gastrectomy-associated collections. Endoscopy. 2017;49(5):504–8.

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of General Surgery, Herbert Wertheim College of Medicine, Florida International University, 17038 West Dixie Hwy #210, Miami, FL, 33160, USA

    Manoel Galvao Neto M.D. & Natan Zundel M.D.

Authors
  1. Manoel Galvao Neto M.D.
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  2. Natan Zundel M.D.
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Correspondence to Manoel Galvao Neto M.D. .

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Editors and Affiliations

  1. Gastrointestinal/Minimally Invasive Surgery, Stritch School of Medicine, Loyola University Medical Center, Maywood, Illinois, USA

    Bipan Chand

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Neto, M.G., Zundel, N. (2018). Comprehensive Endoluminal Treatment of Sleeve Gastrectomy Complications. In: Chand, B. (eds) Endoscopy in Obesity Management. Springer, Cham. https://doi.org/10.1007/978-3-319-63528-6_13

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  • DOI: https://doi.org/10.1007/978-3-319-63528-6_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-63527-9

  • Online ISBN: 978-3-319-63528-6

  • eBook Packages: MedicineMedicine (R0)

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