Endoscopic treatment of postoperative enterocutaneous fistulas after bariatric surgery with the use of a fistula plug: report of five cases
| Autor: | Jacques Devière, Vu Kwan, Sonia Dugardeyn, O. Le Moine, Emmanuel Toussaint, P. Eisendrath |
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| Rok vydání: | 2009 |
| Předmět: |
Adult
Male medicine.medical_specialty Percutaneous medicine.medical_treatment Fistula Bariatric Surgery Young Adult Postoperative Complications Intestinal Fistula medicine Humans In patient Endoscopy Digestive System medicine.diagnostic_test business.industry General surgery Gastroenterology Stent Surgical Instruments medicine.disease Endoscopic Procedure Surgery Endoscopy Combined therapy Female business Endoscopic treatment |
| Zdroj: | Endoscopy. 41:560-563 |
| ISSN: | 1438-8812 0013-726X |
| DOI: | 10.1055/s-0029-1214606 |
| Popis: | Anastomotic leaks frequently occur after bariatric surgery and their management includes different options. The present study describes the management of enterocutaneous fistulas in patients in whom surgical or endoscopic treatments have failed, by insertion of a biomaterial (Surgisis fistula plug) to facilitate healing of the gastrocutaneous fistula. Five patients with leaks after bariatric surgery were treated. All patients had undergone previous failed surgical or endoscopic attempt(s) at closure. Our technique entailed insertion of the Surgisis fistula plug into the fistula tract by a "rendezvous" procedure, via both percutaneous and endoscopic routes. The data were collected retrospectively. Initially, two patients were treated by fistula plug alone and three received fistula plug plus a self-expanding stent. In two patients, cutaneous fistula outflow ceased within a few days. The other three patients required one additional endoscopic procedure. At the end we observed healed leaks in four of the five patients (80 %). The median follow-up duration was 18 months. In conclusion, the combined therapy consisting of fistula plug implantation with optional stenting helps closure in these difficult refractory cases of gastrocutaneous fistula. |
| Databáze: | OpenAIRE |
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