Abstract
Background
Roux-en-Y gastric bypass (RYGB) is amongst the commonest surgical intervention for weight loss in obese patients. Gastrocutaneous fistula, which usually occurs along the vertical staple line of the pouch, is amongst its most alarming complications. Medical management comprised of wound drainage, nutritional support, acid suppression, and antibiotics may be ineffective in as many as a third of patients with this complication. We present outcomes after endoscopic application of SurgiSIS®, which is a novel biomaterial for the treatment of this complication.
Design
A case series of 25 patients.
Methods
Twenty-five patients who had failed conservative medical management of gastrocutaneous fistula after RYGB underwent endoscopic application of SurgiSIS®—an acellular fibrogenic matrix biomaterial to help fistula healing.
Main outcome measures
Fistula closure as assessed by upper gastrointestinal imaging and endoscopic examination.
Results
In patients who had failed medical management lasting 4–25 (median, 7) weeks, closure of the fistulous tract was successful after one application in six patients (30%), two applications in 11 patients (55%), and three applications in three patients (15%). There were no procedure-related complications.
Conclusions
Endoscopic application of SurgiSIS®—an acellular fibrogenic matrix—is safe and effective for the treatment of gastrocutaneous fistula after RYGB.
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The authors thank Atul Kumar for assistance with the manuscript revision.
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Maluf-Filho, F., Hondo, F., Halwan, B. et al. Endoscopic treatment of Roux-en-Y gastric bypass-related gastrocutaneous fistulas using a novel biomaterial. Surg Endosc 23, 1541–1545 (2009). https://doi.org/10.1007/s00464-009-0440-4
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DOI: https://doi.org/10.1007/s00464-009-0440-4