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Use of endoscopic septotomy for the treatment of late staple-line leaks after laparoscopic sleeve gastrectomy
Use of endoscopic septotomy for the treatment of late staple-line leaks after laparoscopic sleeve gastrectomy
- Source :
- Endoscopy. 49(1)
- Publication Year :
- 2016
-
Abstract
- Background Staple-line leak following laparoscopic sleeve gastrectomy is a dire adverse event. While the treatment of acute and early leaks is well established, there is still dispute regarding late and chronic leaks. We describe an endoscopic approach combining septotomy and sleeve stricture dilation for treating late/chronic leaks. Methods Ten consecutive patients with late/chronic proximal leaks were treated at our center. The septum separating the sleeve lumen from the perigastric cavity was progressively dissected over several sessions and the downstream stricture was pneumatically dilated. The technical and clinical success rates were evaluated. Results: All ten patients were treated successfully. Eight patients had sleeve strictures that were dilated in conjunction with septotomy. A mean of five sessions over the course of 43 days was needed to complete treatment. In two patients with a small perigastric cavity and no stricture, septotomy was achieved with through-the-scope balloon dilation of the fistula. No adverse events were encountered. Conclusions Septotomy accompanied by stricture dilation seems highly effective and safe in late and chronic leaks following sleeve gastrectomy.
- Subjects :
- Adult
Male
Leak
medicine.medical_specialty
Sleeve gastrectomy
Time Factors
medicine.medical_treatment
Fistula
Lumen (anatomy)
030209 endocrinology & metabolism
Anastomotic Leak
Constriction, Pathologic
Endoscopy, Gastrointestinal
03 medical and health sciences
0302 clinical medicine
Gastrectomy
Surgical Stapling
medicine
Humans
Laparoscopy
Retrospective Studies
medicine.diagnostic_test
business.industry
Gastroenterology
Perigastric
medicine.disease
Dilatation
Surgery
Chronic Disease
Balloon dilation
030211 gastroenterology & hepatology
Female
Radiology
business
Subjects
Details
- ISSN :
- 14388812
- Volume :
- 49
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- Endoscopy
- Accession number :
- edsair.doi.dedup.....087ac09887f067253ed671c515a68769