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Case report| Volume 4, ISSUE 6, P759-763, November 2008

Use of Roux limb as remedial surgery for sleeve gastrectomy fistulas

Published:August 04, 2008DOI:https://doi.org/10.1016/j.soard.2008.07.012
Use of Roux limb as remedial surgery for sleeve gastrectomy fistulas
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      Laparoscopic sleeve gastrectomy (LSG) is a restrictive operation indicated as an isolated technique or as the first part of the laparoscopic duodenal switch [
      Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery
      Position statement: sleeve gastrectomy as a bariatric procedure.
      Surg Obes Relat Dis. 2007; 3: 573-576
      ,
      • Deitel M.
      • Ros C.
      • Gagner M.
      The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007.
      Obes Surg. 2008; 18 (48746)
      ,
      • Baltasar A.
      • Serra C.
      • Pérez N.
      • et al.
      Laparoscopic sleeve gastrectomy: a multipurpose bariatric operation.
      Obes Surg. 2005; 15: 124-128
      ]. A leak at the esophageal-gastric junction (EGJ), at the uppermost part of the staple line, is, in our experience, the most common site and can lead to local abscess, septic complications, or chronic fistula. Contained leaks have less severe consequences and are usually treated by percutaneous pigtail drainage. Fibrin sealing glues, coils, coated self-expanding stents (CSESs) [
      • Salinas A.
      • Baptista A.
      • Santiago E.
      • et al.
      Self-expanding metal stents to treat gastric leaks.
      Surg Obes Related Dis. 2006; 2: 570-572
      ,
      • Serra C.
      • Baltasar A.
      • Andreo L.
      • et al.
      Treatment of gastric leaks with a coated self-expanding stents after sleeve gastrectomy.
      Obes Surg. 2007; 17: 866-872
      ] or repeat operations have successfully closed these fistulas in some patients but, in others, have failed. Some patients have required total gastrectomy [
      • Serra C.
      • Baltasar A.
      • Pérez N.
      • et al.
      Total gastrectomy for complications of the duodenal switch with reversal.
      Obes Surg. 2006; 16: 1082-1086
      ].

      Keywords

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      References

        • Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery
        Position statement: sleeve gastrectomy as a bariatric procedure.
        Surg Obes Relat Dis. 2007; 3: 573-576
        View in Article
        • Deitel M.
        • Ros C.
        • Gagner M.
        The First International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007.
        Obes Surg. 2008; 18 (48746)
        View in Article
        • Baltasar A.
        • Serra C.
        • Pérez N.
        • et al.
        Laparoscopic sleeve gastrectomy: a multipurpose bariatric operation.
        Obes Surg. 2005; 15: 124-128
        View in Article
        • Salinas A.
        • Baptista A.
        • Santiago E.
        • et al.
        Self-expanding metal stents to treat gastric leaks.
        Surg Obes Related Dis. 2006; 2: 570-572
        View in Article
        • Serra C.
        • Baltasar A.
        • Andreo L.
        • et al.
        Treatment of gastric leaks with a coated self-expanding stents after sleeve gastrectomy.
        Obes Surg. 2007; 17: 866-872
        View in Article
        • Serra C.
        • Baltasar A.
        • Pérez N.
        • et al.
        Total gastrectomy for complications of the duodenal switch with reversal.
        Obes Surg. 2006; 16: 1082-1086
        View in Article
        • Baltasar A.
        • Bou R.
        • Bengochea M.
        • et al.
        Use of a Roux Limb to correct esophagogastric junction fistulas after sleeve gastrectomy.
        Obes Surg. 2007; 17: 1408-1410
        View in Article
        • Marceau P.
        • Biron S.
        • Bourque R.A.
        • et al.
        Biliopancreatic diversion with a new type of gastrectomy.
        Obes Surg. 1993; 3: 29-35
        View in Article
        • Marchesini J.B.
        A safer and simpler technique for the duodenal switch (letter to the editor).
        Obes Surg. 2007; 17: 1136
        View in Article
        • Baltasar A.
        • Serra C.
        • Pérez N.
        • et al.
        Re-sleeve gastrectomy.
        Obes Surg. 2006; 16: 1535-1538
        View in Article

      Article info

      Publication history

      Published online: August 04, 2008
      Accepted: July 21, 2008
      Received in revised form: July 17, 2008
      Received: December 27, 2007

      Footnotes

      Reprints not available from the authors.

      Identification

      DOI: https://doi.org/10.1016/j.soard.2008.07.012

      Copyright

      © 2008 Published by Elsevier Inc.

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