Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases?
Background/Aims Surgeons and endoscopists have started to use endoscopically inserted double pigtail stents (DPTs) in the management of upper gastrointestinal (UGI) leaks, including UGI anastomotic leaks. We investigated our own experiences in this patient population. Methods From March 2017 to June...
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| Format: | Article |
| Language: | English |
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Korean Society of Gastrointestinal Endoscopy
2022-05-01
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| Series: | Clinical Endoscopy |
| Subjects: | |
| Online Access: | http://www.e-ce.org/upload/pdf/ce-2021-197.pdf |
| _version_ | 1797641988400480256 |
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| author | Bin Chet Toh Jingli Chong Baldwin PM Yeung Chin Hong Lim Eugene KW Lim Weng Hoong Chan Jeremy TH Tan |
| author_facet | Bin Chet Toh Jingli Chong Baldwin PM Yeung Chin Hong Lim Eugene KW Lim Weng Hoong Chan Jeremy TH Tan |
| author_sort | Bin Chet Toh |
| collection | DOAJ |
| description | Background/Aims Surgeons and endoscopists have started to use endoscopically inserted double pigtail stents (DPTs) in the management of upper gastrointestinal (UGI) leaks, including UGI anastomotic leaks. We investigated our own experiences in this patient population. Methods From March 2017 to June 2020, 12 patients had endoscopic internal drainage of a radiologically proven anastomotic leak after UGI surgery in two tertiary UGI centers. The primary outcome measure was the time to removal of the DPTs after anastomotic healing. The secondary outcome measure was early oral feeding after DPT insertion. Results Eight of the 12 patients (67%) required only one DPT, whereas four (33%) required two DPTs. The median duration of drainage was 42 days. Two patients required surgery due to inadequate control of sepsis. Of the remaining 10 patients, nine did not require a change in DPT before anastomotic healing. Nine patients were allowed oral fluids within the 1st week and a soft diet in the 2nd week. One patient was allowed clear oral feeds on the 8th day after DPT insertion. Conclusions Endoscopic internal drainage is becoming an established minimally invasive technique for controlling anastomotic leak after UGI surgery. It allows for early oral nutritional feeding and minimizes discomfort from conventional external drainage. |
| first_indexed | 2024-03-11T13:53:40Z |
| format | Article |
| id | doaj.art-d9b27cbbefa444cbbad70935df09b4dc |
| institution | Directory Open Access Journal |
| issn | 2234-2400 2234-2443 |
| language | English |
| last_indexed | 2024-03-11T13:53:40Z |
| publishDate | 2022-05-01 |
| publisher | Korean Society of Gastrointestinal Endoscopy |
| record_format | Article |
| series | Clinical Endoscopy |
| spelling | doaj.art-d9b27cbbefa444cbbad70935df09b4dc2023-11-02T07:39:50ZengKorean Society of Gastrointestinal EndoscopyClinical Endoscopy2234-24002234-24432022-05-0155340140710.5946/ce.2021.1977609Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases?Bin Chet Toh0Jingli Chong1Baldwin PM Yeung2Chin Hong Lim3Eugene KW Lim4Weng Hoong Chan5Jeremy TH Tan6 Upper Gastrointestinal and Bariatric Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore Upper Gastrointestinal and Bariatric Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore Upper Gastrointestinal and Bariatric Service, Department of General Surgery, Sengkang General Hospital, Singapore, Singapore Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore Department of Upper Gastrointestinal and Bariatric Surgery, Singapore General Hospital, Singapore, Singapore Upper Gastrointestinal and Bariatric Service, Department of General Surgery, Sengkang General Hospital, Singapore, SingaporeBackground/Aims Surgeons and endoscopists have started to use endoscopically inserted double pigtail stents (DPTs) in the management of upper gastrointestinal (UGI) leaks, including UGI anastomotic leaks. We investigated our own experiences in this patient population. Methods From March 2017 to June 2020, 12 patients had endoscopic internal drainage of a radiologically proven anastomotic leak after UGI surgery in two tertiary UGI centers. The primary outcome measure was the time to removal of the DPTs after anastomotic healing. The secondary outcome measure was early oral feeding after DPT insertion. Results Eight of the 12 patients (67%) required only one DPT, whereas four (33%) required two DPTs. The median duration of drainage was 42 days. Two patients required surgery due to inadequate control of sepsis. Of the remaining 10 patients, nine did not require a change in DPT before anastomotic healing. Nine patients were allowed oral fluids within the 1st week and a soft diet in the 2nd week. One patient was allowed clear oral feeds on the 8th day after DPT insertion. Conclusions Endoscopic internal drainage is becoming an established minimally invasive technique for controlling anastomotic leak after UGI surgery. It allows for early oral nutritional feeding and minimizes discomfort from conventional external drainage.http://www.e-ce.org/upload/pdf/ce-2021-197.pdfanastomotic leakdrainagestentsupper gastrointestinal tract |
| spellingShingle | Bin Chet Toh Jingli Chong Baldwin PM Yeung Chin Hong Lim Eugene KW Lim Weng Hoong Chan Jeremy TH Tan Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases? Clinical Endoscopy anastomotic leak drainage stents upper gastrointestinal tract |
| title | Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases? |
| title_full | Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases? |
| title_fullStr | Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases? |
| title_full_unstemmed | Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases? |
| title_short | Endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks: suitable for all cases? |
| title_sort | endoscopic internal drainage with double pigtail stents for upper gastrointestinal anastomotic leaks suitable for all cases |
| topic | anastomotic leak drainage stents upper gastrointestinal tract |
| url | http://www.e-ce.org/upload/pdf/ce-2021-197.pdf |
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