Endoscopic Management of Post-bariatric Surgery Fistula: a Tertiary Care Center Experience View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2018-08-03

AUTHORS

Hedi Benosman, Gabriel Rahmi, Guillaume Perrod, Mathieu Bruzzi, Elia Samaha, Ariane Vienne, Charles André Cuenod, Jean Marc Chevallier, Richard Douard, Christophe Cellier

ABSTRACT

Background and Study AimsPost-laparoscopic sleeve gastrectomy (LSG) fistula is a major complication, responsible for high morbidity. Endoscopic treatment represents an alternative to surgical management, with variable approaches and success rates. In this study, we aimed to evaluate the efficacy of endoscopic treatment in a tertiary care center.Patients and MethodsBetween March 2010 and March 2015, all patients referred to our center for endoscopic treatment of fistula related to laparoscopic sleeve gastrectomy were included. The primary endpoint was defined as a complete closure of the fistula without recurrence within the 2 months.ResultsA total of 26 patients were retrospectively included (73% female). The mean time between fistula diagnosis and first endoscopy was 27.4 days (± 22). Twenty-three (88.4%) patients had a complete fistula closure after endoscopic treatment. The healing delay was 76.4 days (± 42.8), and an average of 3.5 (± 1.4) endoscopic procedures were required. Clinical efficacy was 100% when the endoscopic treatment was performed within the first 3 weeks, or 70% afterwards (p = 0.046). The fistula closure rate was similar between patients with endoscopic drainage (with or without other endoscopic techniques) and patient with closing techniques alone (85.7% vs. 89.5%, respectively).ConclusionEndoscopic treatment of fistula after LSG is efficient but requires early procedures within the first 3 weeks. Endoscopic strategies involving closing procedure or drainage procedure seem to be similar, but these data must be confirmed in large prospective clinical studies. More... »

PAGES

3910-3915

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  • Identifiers

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    http://scigraph.springernature.com/pub.10.1007/s11695-018-3432-4

    DOI

    http://dx.doi.org/10.1007/s11695-018-3432-4

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1105977481

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30074143


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