Abstract
Background
This study examined the feasibility of using Polyflex stents in the treatment of enteric
leaks after various bariatric operations. Chronic and acute leaks were treated.
Methods
We performed a retrospective case series review. Four patients received 6 Polyflex
stents to treat complications of bariatric surgery. Two presented with early sepsis
before stenting. One presented with abdominal pain. One presented with a chronic persistent
fistula with an associated abscess. Stenting was performed under endoscopy with fluoroscopic
guidance. The stents were left in place for 6 weeks.
Results
All patients tolerated a clear liquid diet within 24 hours of stenting and were able
to be advanced to a pureed diet. All patients improved clinically after stenting.
Three patients with acute leaks sealed their leaks after stent placement. One patient
with a chronic leak persisted and required operative closure after a second stent
was placed and failed. All patients experienced short-term nausea, as well as early
satiety that lasted the duration of the stenting. One patient experienced hypersialisis
while the stent was in place. Two stents migrated, although this had no effect on
leak closure. One patient had an anastomotic stenosis successfully treated with a
second stent.
Conclusions
Polyflex stents are useful in bypassing acute upper intestinal leaks after various
bariatric operations. They provide a temporary bridge for wound healing with continued
oral intake. Stenting provides a minimally invasive option in the management of acute
leaks and, in our experience, had no serious associated morbidity.
Keywords
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Article info
Publication history
Published online: December 28, 2006
Accepted:
October 13,
2006
Received in revised form:
August 29,
2006
Received:
May 16,
2006
Identification
Copyright
© 2007 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
