1
|
Belle S, Kouladouros K, Kähler G. [Management of Endoscopic Complications after Bariatric Surgery: Focus on Current Endoscopic Therapy]. Zentralbl Chir 2022; 147:539-546. [PMID: 36479650 DOI: 10.1055/a-1962-6910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
In bariatric surgery, complications are rare. Most of the complications can be managed by endoscopy. Rare complications impose a challenge in everyday clinical work. To optimally treat the complications and to minimise the harm to the patient it is important to implement complication management. This review gives an overview of relevant bariatric complications and endoscopic therapy strategies, focusing on published literature of the last five years. This manuscript could be a starting point for complication management in the clinic.
Collapse
Affiliation(s)
- Sebastian Belle
- Zentrale Interdisziplinäre Endoskopie (ZIE), Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - Konstantinos Kouladouros
- Chirurgie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| | - Georg Kähler
- Chirurgie, Universitätsmedizin Mannheim, Medizinische Fakultät Mannheim, Universität Heidelberg, Mannheim, Deutschland
| |
Collapse
|
2
|
Mongardini FM, Cacciatore C, Catauro A, Maglione F, Picardi F, Lauro A, Gambardella C, Allaria A, Docimo L. Stemming the Leak: A Novel Treatment for Gastro-Bronchial Fistula. Dig Dis Sci 2022; 67:5425-5432. [PMID: 36251132 DOI: 10.1007/s10620-022-07711-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 01/05/2023]
Abstract
Laparoscopic sleeve gastrectomy (LSG) is a commonly used procedure in bariatric patients that often has excellent results. Despite its advantages, LSG is burdened by specific intraoperative and postoperative early and late complications. One of the life-threatening complications is gastric fistula, usually treated with a multidisciplinary surgical-endoscopic approach. In case of failure of the latter, alternative nonoperative techniques such as the use of autologous stem cells truly represents an innovative possibility, with only few cases described in literature. Here, we report the case of a 25-year-old man with post-LSG broncho-gastric fistula treated with application of autologous stem cells after the failure of the conventional surgical/endoscopic approach.
Collapse
Affiliation(s)
- F M Mongardini
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.
| | - C Cacciatore
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - A Catauro
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Maglione
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - F Picardi
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - A Lauro
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy.,Department of Surgical Sciences, Sapienza University of Rome, Rome, Italy
| | - C Gambardella
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - A Allaria
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - L Docimo
- General, Mini-invasive, Oncological and Obesity Surgery Unit, University of Campania "Luigi Vanvitelli", Naples, Italy
| |
Collapse
|
3
|
Sakran N, Zakeri R, Madhok B, Graham Y, Parmar C, Mahawar K, Pouwels S. Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options. Obes Surg 2020; 31:357-369. [PMID: 33123868 DOI: 10.1007/s11695-020-05078-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2020] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 12/31/2022]
Abstract
This study aimed to establish the optimal diagnostic and treatment algorithm for the management of gastric fistula in the chest (GFIC) after sleeve gastrectomy (SG) through a systematic review of published cases. A multi-database search was performed, which produced 1182 results, of which 26 studies were included in this systematic review. The initial presentation included subphrenic collections, leaks, or (recurrent) pneumonia with associated symptoms such as persistent cough, fever, and/or dyspnea. Computed tomography (CT) scan in combination with either upper gastrointestinal (UGI) series or an esophagogastroduodenoscopy (EGD) was used to adequately diagnose the fistulas. Initial treatment was either with clips and/or clips and stents that were placed endoscopically. When unsuccessful in the majority of the cases, the surgical treatment consisted of total gastrectomy and Roux-en-Y esophagojejunostomy in a laparoscopic or open fashion.
Collapse
Affiliation(s)
- Nasser Sakran
- Department of Surgery, Emek Medical Center, 21 Izhak Rabin Blvd, 1834111, Afula, Israel. .,The Technion - Israel Institute of Technology, Haifa, Israel.
| | - Roxanna Zakeri
- Department of Surgery, University College London Hospital NHS Foundation Trust, London, UK
| | - Brijesh Madhok
- University Hospital of Derby and Burton NHS Foundation Trust, Derby, UK
| | - Yitka Graham
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Facultad de Psucologia, Universidad Anahuac Mexico, Mexico City, Mexico.,Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | | | - Kamal Mahawar
- Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, UK.,Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, UK
| | - Sjaak Pouwels
- Department of Intensive Care Medicine, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands
| | | |
Collapse
|
4
|
Gastrobronchial Fistula after Robotic Repair of Traumatic Diaphragmatic Hernia. Case Rep Surg 2020; 2020:8085425. [PMID: 32257500 PMCID: PMC7102410 DOI: 10.1155/2020/8085425] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 02/21/2020] [Accepted: 03/02/2020] [Indexed: 12/04/2022] Open
Abstract
Gastrobronchial fistulas are a rare occurrence in the literature. We report a case of a gastrobronchial fistula after robotic repair of a chronic traumatic diaphragmatic hernia. The patient had severe respiratory symptoms with multiple studies that were inconclusive. The fistula was ultimately discovered after an esophagogastroduodenoscopy (EGD). The patient underwent a left thoracotomy for takedown of his fistula and eventually recovered. Earlier EGD and a lower threshold for differential that included this diagnosis would have led to an earlier identification and treatment of a rare disease process.
Collapse
|
5
|
Shoja MM, Ansarin K. Conservative Management of a Delayed Benign Gastrobronchial Fistula: A 20-Year Follow-up. Cureus 2019; 11:e5444. [PMID: 31632889 PMCID: PMC6797007 DOI: 10.7759/cureus.5444] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 08/20/2019] [Indexed: 12/11/2022] Open
Abstract
We describe a case of gastrobronchial fistula (GBF) following a thoracoabdominal gunshot wound in a previously healthy young man. Despite initial surgery, the patient suffered recurrent hemoptysis, and a GBF was diagnosed 18 months after initial presentation. The patient was treated with oral proton pump inhibitors for a prolonged period with the resolution of the fistula. During a follow-up 20 years later, no recurrence of the fistula was noted. The importance of early diagnosis of such fistulae cannot be overstated. This report provides a testimony to the feasibility of the conservative approaches in managing delayed, benign, and post-traumatic GBF.
Collapse
Affiliation(s)
| | - Khalil Ansarin
- Internal Medicine, Tabriz University of Medical Sciences, Tabriz, IRN
| |
Collapse
|