Endoscopic repair of gastric leaks after Roux-en-Y gastric bypass: a less invasive approach - 17/08/11
Boston, Massachusetts, USA
Abstract |
Background |
Gastric leaks represent an important source of morbidity and mortality associated with Roux-en-Y gastric bypass. These leaks, once managed acutely, can become chronic and represent a difficult clinical challenge. Surgical options to address a chronic gastric leak are technically challenging and often unsuccessful. We present a novel peroral endoscopic treatment for patients with chronic gastric leaks after Roux-en-Y gastric bypass.
Design |
Case series.
Interventions |
Repair of chronic gastric leaks after Roux-en-Y gastric bypass by using a combination of argon plasma coagulation, hemoclips, fibrin glue, Polyflex stent placement, and distal gastrojejunal stenosis dilation. The goal was to achieve durable fistula closure and avoid surgery.
Main Outcome Measurements |
Durable fistula closure as assessed by an upper-GI series and clinical evaluation.
Results |
Gastric leak closure was achieved in all 3 patients, with complete resolution of symptoms. Polyflex stent migration into the Roux limb occurred in 1 patient, and this was retrieved endoscopically. There were no other significant complications.
Conclusions |
Peroral endoscopic repair of gastric leaks is technically feasible. This procedure may offer a less invasive alternative to traditional surgical revision.
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Vol 63 - N° 4
P. 710-714 - avril 2006 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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