Efficacy of Endoscopic Treatment of Post-Sleeve Gastrectomy Fistulas According to the Radiological Type View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-03-30

AUTHORS

A. Sportes, G. Aireini, R. Kamel, C. Pratico, J. J. Raynaud, J. M. Sabate, G. Donatelli, R. Benamouzig

ABSTRACT

BACKGROUND AND AIMS: The originality of this retrospective study relies on the evaluation of the effectiveness of the endoscopic internal drainage (EID) according to the type of fistula. METHODS: The type of fistula was classified initially according to a CT scan with oral opacification: fistula without a communicating abscess (type I), fistula with a communicating abscess (type II), and fistula with an abscessed sub- and sus-diaphragmatic communicating collection (type III). Treatment algorithm consisted of the insertion of a nasojejunal feeding tube (NJFT) for type I fistulas and the placement of a NJFT with EID with or without surgical drainage for types II and III. RESULTS: Forty-nine patients were included. The clinical success rate with fistula healing was 100% in group I, 96% in group II, and 12% for group III (p = 0.001). Mean time for diagnosis of the fistula was significantly higher in type III (p = 0.04). The mean estimated size of the defect was higher in type II, 11.2 mm and III, 10 mm versus type I, 2.8 mm (p = 0.001). The average number of scheduled endoscopic sessions were 2, 2.7, and 5.2 for types I, II, and III, respectively (p = 0.001). The number of unscheduled reinterventions was also significantly higher in type III (p = 0.03). The NJFT was left in place for a significantly longer duration in type III (136 days) compared to types I (3, 13) and II (49) p = 0.001. CONCLUSION: This study shows that proper characterization of the type of fistula before the endoscopic treatment of post-sleeve fistulas improves the efficacy of the endoscopic treatment. More... »

PAGES

1-8

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11695-019-03825-4

DOI

http://dx.doi.org/10.1007/s11695-019-03825-4

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1113144225

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/30929198


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