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sleeve gastrectomy fistula

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https://www.readbyqxmd.com/read/29182900/laparoscopic-sleeve-gastrectomy-for-morbid-obesity-role-of-intraluminal-and-intraperitoneal-postoperative-drainage
#1
G Currò, G Piscitelli, C Lazzara, I Komaei, A Fortugno, G Pinto, F Guccione, A Cogliandolo, A Dattola, S Latteri, G Navarra
BACKGROUND AND AIMS: Bleeding and staple line leak are the most common postoperative complications of LSG. To prevent and/or to promptly identify such complications, conventional peri-operative protocols imply post-operative gastric decompression (NGT) and staple line drain (IAD). Our aim was to evaluate the role of naso-gastric tube (NGT) and intra-abdominal drain (IAD) in preventing and/or facilitating identification and treatment of post-operative complications after sleeve gastrectomy...
July 2017: Il Giornale di Chirurgia
https://www.readbyqxmd.com/read/29143089/surgical-treatment-of-gastro-pulmonary-fistula-following-bariatric-surgery-possible-and-safe
#2
Alon Ben Nun, David Simansky, Merav Rokah, Nona Zeitlin, Nir Golan, Ramez Abu Khalil, Michalle Soudack
BACKGROUND: Laparoscopic sleeve gastrectomy is a common surgical management of morbid obesity. Major complication rate is 3-8%. Staple line leak is one of the most serious complications. In a small group of patients, a gastro-pulmonary fistula is formed. Endoscopic and minimally invasive measures are the first line of treatment with considerable success rate. There are very poor data in the literature what should be done in cases of failure. In this paper, we report our positive experience with definitive surgical repair...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29046081/splenic-artery-pseudoaneurysm-causing-delayed-gastrointestinal-bleeding-after-gastrocolonic-fistula-following-sleeve-gastrectomy
#3
J F Ball, L Sreedharan, S Reddy, Bhl Tan, V Sujendran
Delayed gastrointestinal bleeding in the context of a gastric fistula is a very rare complication of longitudinal sleeve gastrectomy. We report the case of a patient who presented with massive gastrointestinal bleeding from a pseudoaneurysm arising from the splenic artery following complications after a longitudinal sleeve gastrectomy several months previously. The case was successfully managed with angiographic embolisation and we present our experience with recommendations for managing this rare but life-threatening complication...
October 19, 2017: Annals of the Royal College of Surgeons of England
https://www.readbyqxmd.com/read/28965309/proximal-gastrectomy-with-double-tract-reconstruction-is-an-alternative-revision-surgery-for-intractable-complications-after-sleeve-gastrectomy
#4
Takashi Oshiro, Yu Sato, Taiki Nabekura, Tomoaki Kitahara, Ayami Sato, Kengo Kadoya, Kentarou Kawamitsu, Ryuichi Takagi, Makoto Nagashima, Shinichi Okazumi, Ryoji Katoh
Gastric leakage and stricture are challenging complications of sleeve gastrectomy (SG). Failure of endoscopic intervention necessitates revision surgery. We describe two cases in which proximal gastrectomy with double tract reconstruction (PG with DTR) was performed in patients with chronic gastric fistula and twisted gastric tube after SG. Following resection of the affected part of the proximal stomach, reconstruction was achieved with three anastomoses [esophagojejunostomy (EJ), gastrojejunostomy (GJ), and jejunojejunostomy]...
September 30, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28895037/management-of-acute-sleeve-gastrectomy-leaks-by-conversion-to-roux-en-y-gastric-bypass-a-small-case-series
#5
Kutay Saglam, Aydin Aktas, Ersin Gundogan, Ismail Ertugrul, Ali Tardu, Servet Karagul, Serdar Kirmizi, Fatih Sumer, Veysel Ersan, Cuneyt Kayaalp
Management of early sleeve gastrectomy leak remains challenging. The recommended approach is endoscopic stenting and abdominal drainage. Conversion to a Roux-en-Y gastric bypass (RYGB) is a common procedure used for late fistulas with distal obstruction. Here, we have presented three cases of early staple line leaks treated by conversion to RYGB. These patients had uncontrolled abdominal infections despite intensive medical treatments, and surgery was elected for abdominal drainage as well as to control the source of sepsis...
November 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28866827/fistula-following-laparoscopic-sleeve-gastrectomy-a-proposed-classification-and-algorithm-for-optimal-management
#6
G Al Hajj, R Chemaly
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) is an accepted restrictive procedure with a hormonal component. There is no definitive course of treatment for post-LSG fistula; it remains a feared complication. We aimed to classify post-LSG fistulas and propose an algorithm to optimize their treatment. METHODS: Following primary and revisional LSG in obese patients, a retrospective observational study of fistulas was undertaken. Radiological studies were performed to identify anatomically distinct types of fistulas...
September 2, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28840492/proximal-leakage-after-laparoscopic-sleeve-gastrectomy-an-analysis-of-preoperative-and-operative-predictors-on-1738-consecutive-procedures
#7
Giovanni Cesana, Stefano Cioffi, Riccardo Giorgi, Roberta Villa, Matteo Uccelli, Francesca Ciccarese, Giorgio Castello, Bruno Scotto, Stefano Olmi
BACKGROUND: The purpose of this paper was to search for predictive factors for proximal leakage after laparoscopic sleeve gastrectomy (LSG) in a large cohort from a single referral center. MATERIALS AND METHODS: One thousand seven hundred and thirty-eight patients, collected in a prospectively held database from 2008 to 2016, were retrospectively analyzed. The correlation between postoperative leakage and both preoperative (age, gender, height, weight, BMI, and obesity-related morbidities) and operative variables (the distance from pylorus at which the gastric section was started, operative time, experience of surgeons who performed the LSG, and the surgical materials used) was analyzed...
August 24, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28776154/sleeve-gastrectomy-after-liver-transplantation-feasibility-and-outcomes
#8
Michael Osseis, Andrea Lazzati, Chady Salloum, Concepcion Gomez Gavara, Philippe Compagnon, Cyrille Feray, Chetana Lim, Daniel Azoulay
BACKGROUND: Knowledge regarding the feasibility and safety of sleeve gastrectomy (SG) in obese liver transplant recipients is scarce. We report our experience of sleeve gastrectomy following liver transplantation (LT). METHODS: All patients who had undergone LT and subsequently underwent SG at our institution were retrospectively reviewed. Surgical outcomes, liver and kidney function tests, outcomes of obesity-related comorbidities, and excess weight loss were analyzed...
August 3, 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28750839/endoscopic-treatment-of-fistulas-after-sleeve-gastrectomy-a-comparison-of-internal-drainage-versus-closure
#9
Diane Lorenzo, Théophile Guilbaud, Jean Michel Gonzalez, Alban Benezech, Anne Dutour, Sandrine Boullu, Stéphane Berdah, Thierry Bège, Marc Barthet
BACKGROUND AND AIMS: Post-sleeve gastrectomy fistulas (PSGF) are major adverse events of bariatric surgery. The endoscopic management strategy evolved from closure to internal drainage (ID) after 2013. The main objective was to evaluate and compare these different approaches. METHODS: This retrospective study included all patients treated for PSGF in a referral center. "Closure" management was defined as initial treatment using covered-metal-stent and/or endoclips...
July 24, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/28726146/an-odyssey-of-complications-from-band-to-sleeve-to-bypass-definitive-laparoscopic-completion-gastrectomy-with-distal-esophagectomy-and-esophagojejunostomy-for-persistent-leak
#10
Hideo Takahashi, Andrew T Strong, Alfredo D Guerron, John H Rodriguez, Matthew Kroh
INTRODUCTION: Anastomotic leaks are uncommon yet potentially devastating complications after bariatric surgery. While the initial management includes resuscitation and sepsis control, the definitive management often requires endoscopic or surgical interventions. Surgical revision of the initial surgery may be necessary for chronic non-healing fistula. PATIENTS AND METHODS: The patient is a 45-year-old female with history of laparoscopic adjustable gastric banding who underwent band removal and conversion to a sleeve gastrectomy (SG) due to her failed weight loss, which resulted in a leak at gastroesophageal junction...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28681283/the-visualization-of-gastro-esophageal-junction-vascular-supply-during-a-laparoscopic-sleeve-gastrectomy-role-of-a-new-device
#11
Mario Musella, Marco Milone, Paolo Bianco, Francesco Milone
Leaks arising at the level of gastro-esophageal junction remain a major complication in patients who undergo a laparoscopic sleeve gastrectomy. Besides technical pitfalls, these fistulas are mainly attributable to tissue ischemia following the preparation of the gastric sleeve, explained by the irregular vascularization often present in the area of the gastro-esophageal junction. This video presentation shows how, the utilization of a new model of bougie can be of help in preventing a leak, allowing a better visualization of the particular vascular anatomy present at the level of the gastro-esophageal junction area...
December 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28458855/esophagopericardial-fistula-an-unexpected-dreaded-complication-of-treatment-of-leak-following-revisional-sleeve-gastrectomy-by-endoscopic-internal-drainage
#12
Hugo Meunier, Benjamin Menahem, Andrea Mulliri, Audrey Fohlen, Nicolas Contival, Yannick Le Roux, Julien Desgue, Jean Lubrano, Arnaud Alves
Esophagopericardial fistula (EPF) is an uncommon but life-threatening complication of upper gastrointestinal tract surgery or endoscopy, which is related to anastomotic breakdown, chronic infection or esophageal traumatism. We first describe the first case of an EPF secondary to double pigtail drain migration: an endoscopic internal approach for the treatment of leak following revisional sleeve gastrectomy.
March 2017: Journal of Surgical Case Reports
https://www.readbyqxmd.com/read/28458144/gastropleural-fistula-after-single-anastomosis-gastric-bypass-a-case-report-and-review-of-the-literature
#13
Haider Al-Shurafa, Saleh Alghamdi, Ali Albenmousa, Haifa Alolayan, Zahraa Al-Shurafa
INTRODUCTION: Pulmonary complications after bariatric surgeries are rare but usually serious. They often occur early after surgery but the presentation might be delayed for several months. Gastropleural fistula after bariatric surgery is extremely rare and has been reported in a very small number of patients post sleeve gastrectomy and gastric bypass. CASE PRESENTATION: A 37-year-old lady presented with left sided pleural effusion and empyema 2 years post single anastomosis gastric bypass surgery...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28456885/impact-of-three-dimensional-laparoscopy-in-a-bariatric-surgery-program-influence-in-the-learning-curve
#14
Esther Mariño Padin, Raquel Sánchez Santos, Sonia González Fernández, Antonia Brox Jimenez, Sergio Estevez Fernández, Ester Carrera Dacosta, Agata Rial Duran, Maria Artime Rial, Ivan Dominguez Sanchez
INTRODUCTION: 3D laparoscopy allows the surgeon to regain the sense of depth and improve accuracy. The aim of the study was to assess the impact of 3D in bariatric surgery. PATIENTS AND METHODS: A retrospective cohort study was conducted. All our patients who underwent bariatric surgery (sleeve gastrectomy (SG) or gastric bypass (GB)) between 2013 and 2016 were included. We compared 3D laparoscopy cohort and 2D laparoscopy cohort. Variables are as follows: age, sex, DM, hypertension, surgeon experience, and type of intervention...
October 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28440519/-prevention-diagnosis-and-treatment-of-perioperative-complications-of-bariatric-and-metabolic-surgery
#15
Haifu Wu, Ming Zhong, Di Zhou, Chenye Shi, Heng Jiao, Wei Wu, Xinxia Chang, Jing Cang, Hua Bian
Surgical operation in treating obesity and type 2 diabetes is popularizing rapidly in China. Correct prevention and recognition of perioperation-related operative complications is the premise of ensuring surgical safety. Familiar complications of the operation include deep venous thrombosis, pulmonary artery embolism, anastomotic bleeding, anastomotic fistula and marginal ulcer. The prevention of deep venous thrombosis is better than treatment. The concrete measures contain physical prophylaxis (graduated compression stocking and intermittent pneumatic compression leg sleeves) and drug prophylaxis (unfractionated heparin and low molecular heparin), and the treatment is mainly thrombolysis or operative thrombectomy...
April 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28353180/efficacy-and-safety-of-the-over-the-scope-clip-otsc-system-in-the-management-of-leak-and-fistula-after-laparoscopic-sleeve-gastrectomy-a-systematic-review
#16
Saeed Shoar, Lauren Poliakin, Zhamak Khorgami, Rebecca Rubenstein, Moamena El-Matbouly, Jun L Levin, Alan A Saber
BACKGROUND: Endoscopic management of leaks/fistulas after laparoscopic sleeve gastrectomy (LSG) is gaining popularity in the bariatric surgery. OBJECTIVES: This study aimed to review the efficacy and safety of over-the-scope-clip (OTSC) system in endoscopic closure of post-LSG leak/fistula. METHODS: PubMed/Medline and major journals of the field were systematically reviewed for studies on endoscopic closure of post-LSG leaks/fistula by means of the OTSC system...
September 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28349296/roux-en-y-fistulojejunostomy-a-new-therapeutic-option-for-complicated-post-sleeve-gastric-fistulas-video-report
#17
Theodoros Thomopoulos, Maximilien Thoma, Benoit Navez
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has become during the last few years the most frequent procedure in bariatric surgery. However, complications related to the gastric staple line can be even more serious. The incidence of gastric fistula after LSG varies from 1 to 7%. Its management can be very challenging and long. In case of chronic fistula and failure of the previous treatment, total gastrectomy or Roux-en-Y fistulo-jejunostomy (RYFJ) might be considered. RYFJ has been described very rarely as a salvage procedure of gastric leaks after LSG...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28349295/endoscopic-drainage-of-intra-abdominal-collection-after-bariatric-surgery
#18
Gianfranco Donatelli, Renaud Chiche, Fabrizio Cereatti, Guillaume Pourcher, David Fuks, Bertrand Vergeau, Jean-Loup Dumont, Bruno Meduri
INTRODUCTION: Symptomatic intra-abdominal collection after bariatric surgery occurs in up to 5% of cases. Surgical, percutaneous, or endoscopic drainage are the feasible approaches. MATERIALS AND METHODS: In this video, we show the case report of a 50-year-old woman who underwent to gastric omega bypass on a previous sleeve gastrectomy. After 3 weeks, she presented a well-organized liquid collection just behind the longitudinal staple line of the gastric pouch...
June 2017: Obesity Surgery
https://www.readbyqxmd.com/read/28324798/conservative-management-of-an-unusual-bilioduodenal-fistula-post-laparoscopic-duodeno-ileal-switch-sadi-s-case-report
#19
E Chelala, E Adam, A Rizk, E Makhoul
INTRODUCTION: Single anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is an advanced operation for morbid obesity. To our knowledge, no internal Biliodigestive Fistula has yet been reported as specific complication in the field of metabolic and bariatric Biliopancreatic diversion. CASE PRESENTATION: In this case report, we detail the case of a 57-year-old man who underwent a Single Anastomosis Duodeno-Ileal Switch (SADI-S) bariatric procedure for morbid obesity...
2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28237561/evolution-of-endoscopic-treatment-of-sleeve-gastrectomy-leaks-from-partially-covered-to-long-fully-covered-stents
#20
Fabio Garofalo, Maxime Noreau-Nguyen, Ronald Denis, Henri Atlas, Pierre Garneau, Radu Pescarus
BACKGROUND: Laparoscopic sleeve gastrectomy (SG) has become a widely accepted option in the treatment of morbid obesity. Gastric leaks after SG occur in .9%-2.2% of the patients, mostly at the gastroesophageal junction. The current treatment algorithm includes drainage, antibiotics, nutritional support, and endoluminal control. OBJECTIVES: Our hypothesis is that long, fully covered stents represent a safe, effective solution for SG leaks. SETTING: University hospital...
June 2017: Surgery for Obesity and related Diseases: Official Journal of the American Society for Bariatric Surgery
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