Surgery for Obesity and Related Diseases
Volume 6, Issue 3 , Pages 282-288 , May 2010

Endoscopic repair of gastrogastric fistula after Roux-en-Y gastric bypass: a less-invasive approach

  • Gloria Fernandez-Esparrach, M.D., Ph.D.

      Affiliations

    • Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • David B. Lautz, M.D.

      Affiliations

    • Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
    • ,
  • Christopher C. Thompson, M.D., M.Sc., F.A.C.G., F.A.S.G.E.

      Affiliations

    • Division of Gastroenterology, Brigham and Women's Hospital, Boston, Massachusetts
    • Corresponding Author InformationReprint requests: Christopher C. Thompson, M.D., M.Sc., F.A.C.G., F.A.S.G.E., Developmental Endoscopy, Division of Gastroenterology, Brigham and Women's Hospital, 75 Francis Street, Boston, MA 02115

Received 7 July 2009 ,Revised 26 January 2010 ,Accepted 5 February 2010.

References 

  1. Sjöström L, Lindroos AK, Peltonen M, et al. Swedish Obese Subjects Study Scientific Group Lifestyle, diabetes, and cardiovascular risk factors 10 years after bariatric surgery. N Engl J Med. 2004;351:2683–2693
  2. Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic gastric Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232:515–529
  3. Mun EC, Blackburn GL, Matthews JB. Current status of medical and surgical therapy for obesity. Gastroenterology. 2001;120:669–681
  4. Hamad GG. The state of the art in bariatric surgery for weight loss in the morbidity obese patients. Clin Plast Surg. 2004;31:591–600
  5. Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47:1345–1351
  6. Simpfendorfer CH, Szomstein S, Rosenthal R. laparoscopic gastric bypass for refractory morbid obesity. Surg Clin North Am. 2005;85:119–127
  7. Cucchi SG, Pories WJ, MacDonald KG, Morgan EJ. Gastrogastric fistulas: a complication of divided gastric bypass surgery. Ann Surg. 1995;221:387–391
  8. Capella JF, Capella RF. Gastro-gastric fistulas and marginal ulcers in gastric bypass procedures for weight reduction. Obes Surg. 1999;9:22–27
  9. Carrodeguas L, Szomstein S, Soto F, et al. Management of gastrogastric fistulas after divided Roux-en-Y gastric bypass surgery for morbid obesity: analysis of 1,292 consecutive patients and review of literature. Surg Obes Relat Dis. 2005;1:467–474
  10. Gustavsson S, Sundbom M. Excellent weight result after Roux-en-Y gastric bypass in spite of gastro-gastric fistula. Obes Surg. 2003;13:457–459
  11. MacLean LD, Rhode BM, Nohr C, Katz S, McLean AP. Stomal ulcer after gastric bypass. J Am Coll Surg. 1997;185:1–7
  12. Merrifield BF, Lautz D, Thompson CC. Endoscopic repair of gastric leaks after Roux-en-Y gastric bypass: a less invasive approach. Gastrointest Endosc. 2006;63:710–714
  13. Qadeer MA, Dumot JA, Vargo JJ, Lopez AR, Rice TW. Endoscopic clips for closing esophageal perforations: case report and pooled analysis. Gastrointest Endosc. 2007;66:605–611
  14. Abe N, Sugiyama M, Hashimoto Y, et al. Endoscopic nasomediastinal drainage followed by clip application for treatment of delayed esophageal perforation with mediastinitis. Gastrointest Endosc. 2001;54:646–648
  15. Raymer GS, Sadana A, Campbell DB, Rowe WA. Endoscopic clip application as an adjunct to closure of mature esophageal perforation with fistulae. Clin Gastroenterol Hepatol. 2003;1:44–50
  16. Cipolletta L, Bianco MA, Rotondano G, Marmo R, Piscopo R, Meucci C. Endoscopic clipping of perforation following pneumatic dilation of esophagojejunal anastomotic strictures. Endoscopy. 2000;32:720–722
  17. Rábago LR, Ventosa N, Castro JL, Marco J, Herrera N, Gea F. Endoscopic treatment of postoperative fistulas resistant to conservative management using biological fibrin glue. Endoscopy. 2002;34:632–638
  18. Petersen B, Barkun A, Carpenter S, et al. Technology Assessment Committee, American Society for Gastrointestinal Endoscopy Tissue adhesives and fibrin glues. Gastrointest Endosc. 2004;60:327–333
  19. Maluf-Filho F, Moura E, Sakai P, et al. Endoscopic treatment of esophagogastric fistulae with an acellular matrix. Gastrointest Endosc. 2004;59:AB151
  20. Scappaticci E, Ardissone F, Baldi S, et al. Closure of an iatrogenic tracheo-esophageal fistula with bronchoscopic gluing in a mechanically ventilated adult patient. Ann Thorac Surg. 2004;77:328–329
  21. Thompson CC, Slattery J, Bundga ME, Lautz DB. Peroral endoscopic reduction of dilated gastrojejunal anastomosis after Roux-en-Y gastric bypass: a possible new option for patients with weight regain. Surg Endosc. 2006;20:1744–1748
  22. Pai RD, Doktor V, Lautz DB, Thompson CC. Peroral endoscopic repair of fistulae in Roux-en-Y gastric bypass patients: a clinical experience in 25 patients. Gastroenterology. 2007;132:A79
  23. Thompson C, Carr-Locke D. Novel endoscopic approaches to common bariatric postoperative complications. In: ASGE Video Forum; DDW. New Orleans. 2004;
  24. Felsher J, Farres H, Chand B, Farver C, Ponsky J. Mucosal apposition in endoscopic suturing. Gastrointest Endosc. 2003;58:867–870
  25. Hedberg J, Hedenström H, Nilsson S, Sundbom M, Gustavsson S. Role of gastric acid in stomal ulcer after gastric bypass. Obes Surg. 2005;15:1375–1378
  26. Kolakowski S, Kirkland ML, Schuricht AL. Routine postoperative upper gastrointestinal series after Roux-en-Y gastric bypass: determination of whether it is necessary. Arch Surg. 2007;142:930–934
  27. Serafini F, Anderson W, Ghassemi P, Poklepovic J, Murr MM. The utility of contrast studies and drains in the management of patients after Roux-en-Y gastric bypass. Obes Surg. 2002;12:34–38
  28. Cho M, Kaidar-Person O, Szomstein S, Rosenthal RJ. Laparoscopic remnant gastrectomy: a novel approach to gastrogastric fistula after Roux-en-Y gastric bypass for morbid obesity. J Am Coll Surg. 2007;204:617–624
  29. Raju GS, Ahmed I, Xiao SY, et al. Controlled trial of immediate endoluminal closure of colon perforations in a porcine model by use of a novel clip device. Gastrointest Endosc. 2006;64:989–997
  30. Raju GS, Ahmed I, Brining D, Xiao SY. Endoluminal closure of large perforations of colon with clips in a porcine model. Gastrointest Endosc. 2006;64:640–646
  31. Kumar R, Naik S, Tiwari N, Sharma S, Varsheney S, Pruthi HS. Endoscopic closure of fecal colo-cutaneous fistula by using metal clips. Surg Laparosc Endosc Percutan Tech. 2007;17:447–451
  32. Gutiérrez San Román C, Barrios JE, Lluna J, et al. Long-term assessment of the treatment of recurrent tracheoesophageal fistula with fibrin glue associated with diathermy. J Pediatr Surg. 2006;41:1870–1873
  33. Garcia-Caballero M, Carbajo M, Martinez-Moreno JM, Sarria M, Osorio D, Carmona JA. Drain erosion and gastro-jejunal fistula after one-anastomosis gastric bypass: endoscopic occlusion by fibrin sealant. Obes Surg. 2005;15:719–722
  34. Lee MG, Provost DA, Jones DB. Use of fibrin sealant in laparoscopic gastric bypass for the morbidly obese. Obes Surg. 2004;14:1321–1326
  35. Papavramidis ST, Eleftheriadis EE, Apostolidis DN, Kotzampassi KE. Endoscopic fibrin sealing of high-output non-healing gastrocutaneous fistulas after vertical gastroplasty in morbidly obese patients. Obes Surg. 2001;11:766–769
  36. Papavramidis ST, Eleftheriadis EE, Papavramidis TS, Kotzampassi KE, Gamvros OG. Endoscopic management of gastrocutaneous fistula after bariatric surgery by using a fibrin sealant. Gastrointest Endosc. 2004;59:296–300
  37. Shikora SA, Kim JJ, Tarnoff ME. Reinforcing gastric staple-lines with bovine pericardial strips may decrease the likelihood of gastric leak after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13:37–44
  38. Gumbs AA, Duffy AJ, Bell RL. Management of gastrogastric fistula after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2006;2:117–121
  39. van Bodegraven AA, Kuipers EJ, Bonenkamp HJ, Meuwissen SG. Esophagopleural fistula treated endoscopically with argon beam electrocoagulation and clips. Gastrointest Endosc. 1999;50:407–409

 G. Fernandez-Esparrach was supported by a grant from Generalitat de Catalunya (AGAUR, BE-100022).G. Fernandez-Esparrach is currently at Hospital Clínic, University of Barcelona, IDIBAPS, CIBEREHD, Barcelona, Spain.

PII: S1550-7289(10)00076-6

doi: 10.1016/j.soard.2010.02.036

Surgery for Obesity and Related Diseases
Volume 6, Issue 3 , Pages 282-288 , May 2010

Article Tools

* Image Usage & Resolution