1. Role of Endoscopic Internal Drainage in Treating Gastro-Bronchial and Gastro-Colic Fistula After Sleeve Gastrectomy
- Author
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Jean-Marc Chevallier, Giovanni Galasso, F.P. Zito, Roberto Arienzo, Fabrizio Cereatti, Cristiano Giardiello, Gianfranco Donatelli, Alessandra D’Alessandro, Filippo Pacini, D'Alessandro, A., Galasso, G., Zito, F. P., Giardiello, C., Cereatti, F., Arienzo, R., Pacini, F., Chevallier, J. -M., and Donatelli, G.
- Subjects
Gastric Fistula ,Sleeve gastrectomy ,medicine.medical_specialty ,Colic ,Post-bariatric surgery complication ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Fistula ,Population ,Double pigtail stent ,Anastomotic Leak ,Endoscopic internal drainage ,EID ,Gastro-colic fistula ,Retrospective Studie ,Gastrectomy ,Gastro ,Humans ,Medicine ,Drainage ,education ,Adverse effect ,Retrospective Studies ,education.field_of_study ,Nutrition and Dietetics ,business.industry ,Gastro-bronchial fistula ,medicine.disease ,Obesity, Morbid ,Surgery ,Treatment Outcome ,Laparoscopy ,business ,Complication ,Gastrocolic reflex ,Human - Abstract
Background: Gastro-bronchial and gastro-colic fistulas (GB-GC) represent a rare, but serious complication after laparoscopic sleeve gastrectomy (LSG). The aim of this study is to evaluate the efficacy of endoscopic first-line approach with endoscopic internal drainage (EID) by inserting double pigtail stents (DPS) Methods: We retrospectively analyzed data from 40 consecutive patients referred at two tertiary centers for gastro-bronchial (N=30) and gastrocolic (N=10) fistulas following LSG. Nineteen patients previously experienced emergency surgical drainage. The mean interval between the index surgery and endoscopic fistula treatment was 265.6±521 days. Results: Healing of the fistulous tract was achieved in 19 patients (47.5%), with complete resolution at an average follow-up of 16 months. Mean time of treatment duration was 157.8±141 days with 5.0±2.9 endoscopic sessions. No major adverse events were registered. Conclusions: Despite complete fistula healing was achieved in less than 50% of our population, EID for GB/GC fistula after LSG still represents the most conservative approach with low complications rate. Previous surgical drainage seems to be a positive prognostic factor for endoscopic healing. While the longer the interval between the index surgery and endoscopic treatment, the lower was the rate of treatment success. Graphical abstract: [Figure not available: see fulltext.]
- Published
- 2021
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