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Fibrin Glue and Stents in the Treatment of Gastrojejunal Leaks after Laparoscopic Gastric Bypass: A Case Series and Review of the Literature

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Abstract

Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most commonly performed bariatric/metabolic operation in Europe. Different treatment options for the management of gastrojejunal (GJ) leaks following LRYGB have been published. We looked at our own experience with GJ leaks after 645 consecutive LRYGB operations and reviewed the literature with focus on the use of fibrin sealant and self-expandable metal stents as treatment options. Patient data were prospectively collected in the hospital’s database for bariatric patients. All patients with confirmed GJ leaks were reviewed. Patients with GJ leaks were actively treated by a combination of laparoscopic drainage and endoscopic fibrin sealant injections and/or stenting. Six patients (0.93 %) have been treated for GJ leaks. All leaks were successfully treated and there was no leak-related mortality. The mean (SD) time for closure of the leaks and length of hospital stay was 19.5 days (6.2) and 23.2 days (3.7). The literature concerning endoscopic treatment options in case of GJ leaks following LRYGB operations is scarce and inconclusive. Immediate and active treatment with a combination of operative and endoscopic treatment options, rather than choosing only one treatment over another, may enhance the recovery process.

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Conflict of Interest

The authors Mikael Victorzon, Sarita Victorzon, and Pipsa Peromaa-Haavisto declares no conflict of interest.

Funding

This study was financially supported by the Competitive State Research Financing of the Expert Responsibility area of Vaasa Central Hospital, grant number 100423.

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Authors and Affiliations

  1. Department of Gastrointestinal and Bariatric Surgery, Vaasa Central Hospital, Vaasa, Finland

    Pipsa Peromaa-Haavisto

  2. Department of Radiology, Vaasa Hospital District, Hietalahdenkatu 2-4, 65130, Vaasa, Finland

    Sarita Victorzon

  3. Department of Gastrointestinal Surgery, Vaasa Central Hospital, Hietalahdenkatu 2-4, 65130, Vasa, Finland

    Mikael Victorzon

Authors
  1. Mikael Victorzon
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  2. Sarita Victorzon
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  3. Pipsa Peromaa-Haavisto
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Correspondence to Mikael Victorzon.

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Victorzon, M., Victorzon, S. & Peromaa-Haavisto, P. Fibrin Glue and Stents in the Treatment of Gastrojejunal Leaks after Laparoscopic Gastric Bypass: A Case Series and Review of the Literature. OBES SURG 23, 1692–1697 (2013). https://doi.org/10.1007/s11695-013-1048-2

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