Back to Search
Start Over
New endoscopic technique for the treatment of large gastric fistula or gastric stenosis associated with gastric leaks after sleeve gastrectomy.
- Source :
-
Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery [Surg Obes Relat Dis] 2016 Sep - Oct; Vol. 12 (8), pp. 1577-1584. Date of Electronic Publication: 2016 Apr 28. - Publication Year :
- 2016
-
Abstract
- Background: Covered stent (CS) is required when gastric leak (GL) after sleeve gastrectomy is combined with gastric stenosis (GS) or when a large (>2 cm in diameter) gastric fistula is present (increasing the likelihood of double pigtail stent [DPS] migration).<br />Objective: To compare the results of our previous endoscopic management of large GL or GS associated with GL (using CS only) with those of our new endoscopic treatment (using combined CS and DPS).<br />Setting: University hospital, France, public practice.<br />Material and Methods: Between January 2009 and June 2015, all patients treated for large GL or GS associated with GL after sleeve gastrectomy (n = 20 patients) were included. Our previous endoscopic management required CS placement (CS group), whereas our new endoscopic treatment required combined CS and DPS placement (CS+DPS group). The primary efficacy endpoint was the treatment duration after CS placement until closure of the GL. The secondary efficacy endpoints were the number of endoscopic procedures, the stent migration rate, and the failure rate.<br />Results: Nine patients were treated by CS only (CS group), whereas 11 patients were treated by both CS and DPS (CS+DPS group). The median time to GL closure after CS placement was 84 days (33-130) in the CS group and 32 days (26-89) in the CS+DPS group (P≤.05). The median number of endoscopic procedures at the time of CS placement was 2 (1-3) in the CS group and 1 (1-2) in the CS+DPS group (P≤.05). The stent migration rate after CS placement was 33.3% in the CS group and 0% in the CS+DPS group (P = .21), and the failure rate was 11% and 0% (P = .36).<br />Conclusion: The combination of CS and DPS constitutes an effective treatment for large GL or GS associated with GL, allowing significantly fewer endoscopic procedures and a shorter treatment duration.<br /> (Copyright © 2016 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.)
- Subjects :
- Adult
Anastomotic Leak etiology
Bariatric Surgery adverse effects
Constriction, Pathologic etiology
Constriction, Pathologic surgery
Female
Humans
Male
Middle Aged
Prospective Studies
Reoperation methods
Retrospective Studies
Stomach Diseases etiology
Stomach Diseases surgery
Young Adult
Gastrectomy adverse effects
Gastric Fistula etiology
Gastric Fistula surgery
Gastroscopy methods
Stents
Subjects
Details
- Language :
- English
- ISSN :
- 1878-7533
- Volume :
- 12
- Issue :
- 8
- Database :
- MEDLINE
- Journal :
- Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
- Publication Type :
- Academic Journal
- Accession number :
- 27423535
- Full Text :
- https://doi.org/10.1016/j.soard.2016.04.026