Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy
Background and study aims Sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the world. Leaks are the most feared complications after this procedure. Endoscopic septotomy has been described as a resolution technique that could be useful in the setting of late and chronic...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Georg Thieme Verlag KG
2020-01-01
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| Series: | Endoscopy International Open |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1027-6888 |
| _version_ | 1828304623781281792 |
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| author | Ramon Diaz Leonard K. Welsh Juan Esteban Perez Andres Narvaez Gerardo Davalos Dana Portenier A. Daniel Guerron |
| author_facet | Ramon Diaz Leonard K. Welsh Juan Esteban Perez Andres Narvaez Gerardo Davalos Dana Portenier A. Daniel Guerron |
| author_sort | Ramon Diaz |
| collection | DOAJ |
| description | Background and study aims Sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the world. Leaks are the most feared complications after this procedure. Endoscopic septotomy has been described as a resolution technique that could be useful in the setting of late and chronic leaks. We present our experience in the management of gastric leaks with this advanced endoscopic technique.
Patients and methods Retrospective review of patients who have been admitted to our hospital from January 2016 to December 2018.
Results Five patients were found. All had their index surgery in outside hospitals. The average age was 51 years (range 40 – 69), and four patients were female. Mean time from LSG to leak presentation was 15 days (range 7 – 25). Mean time from leak presentation to septotomy procedure was 61 days (range 21 – 110). All patients were treated with sleeve dilatation before septotomy using endoscopic achalasia balloons. Mean procedure time was 79 minutes (range 55 – 125). Success was achieved in 80 % of patients, and no complications related to the procedure were identified. One patient underwent total gastrectomy for definitive management. Mean follow-up time was 14.25 months (range 6 – 26), and the average time for fistula closure was 60.25 days.
Conclusion Endoscopic septotomy is safe and effective for management of chronic leaks after LSG. Associated non-selective dilatation may be a crucial step to allow distal patency and axis rectification for appropriate leak closure. |
| first_indexed | 2024-04-13T14:14:49Z |
| format | Article |
| id | doaj.art-f525abcfa5c540afa7711aca7c2fa414 |
| institution | Directory Open Access Journal |
| issn | 2364-3722 2196-9736 |
| language | English |
| last_indexed | 2024-04-13T14:14:49Z |
| publishDate | 2020-01-01 |
| publisher | Georg Thieme Verlag KG |
| record_format | Article |
| series | Endoscopy International Open |
| spelling | doaj.art-f525abcfa5c540afa7711aca7c2fa4142022-12-22T02:43:42ZengGeorg Thieme Verlag KGEndoscopy International Open2364-37222196-97362020-01-010801E70E7510.1055/a-1027-6888Endoscopic septotomy as a treatment for leaks after sleeve gastrectomyRamon Diaz0Leonard K. Welsh1Juan Esteban Perez2Andres Narvaez3Gerardo Davalos4Dana Portenier5A. Daniel Guerron6Division of Minimally Invasive Surgery, Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina, United StatesDivision of Minimally Invasive Surgery, Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina, United StatesDivision of Minimally Invasive Surgery, Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina, United StatesDivision of Minimally Invasive Surgery, Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina, United StatesDivision of Minimally Invasive Surgery, Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina, United StatesDivision of Minimally Invasive Surgery, Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina, United StatesDivision of Minimally Invasive Surgery, Metabolic and Weight Loss Surgery, Department of Surgery, Duke University Health System, Durham, North Carolina, United StatesBackground and study aims Sleeve gastrectomy (LSG) is the most commonly performed bariatric procedure in the world. Leaks are the most feared complications after this procedure. Endoscopic septotomy has been described as a resolution technique that could be useful in the setting of late and chronic leaks. We present our experience in the management of gastric leaks with this advanced endoscopic technique. Patients and methods Retrospective review of patients who have been admitted to our hospital from January 2016 to December 2018. Results Five patients were found. All had their index surgery in outside hospitals. The average age was 51 years (range 40 – 69), and four patients were female. Mean time from LSG to leak presentation was 15 days (range 7 – 25). Mean time from leak presentation to septotomy procedure was 61 days (range 21 – 110). All patients were treated with sleeve dilatation before septotomy using endoscopic achalasia balloons. Mean procedure time was 79 minutes (range 55 – 125). Success was achieved in 80 % of patients, and no complications related to the procedure were identified. One patient underwent total gastrectomy for definitive management. Mean follow-up time was 14.25 months (range 6 – 26), and the average time for fistula closure was 60.25 days. Conclusion Endoscopic septotomy is safe and effective for management of chronic leaks after LSG. Associated non-selective dilatation may be a crucial step to allow distal patency and axis rectification for appropriate leak closure.http://www.thieme-connect.de/DOI/DOI?10.1055/a-1027-6888 |
| spellingShingle | Ramon Diaz Leonard K. Welsh Juan Esteban Perez Andres Narvaez Gerardo Davalos Dana Portenier A. Daniel Guerron Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy Endoscopy International Open |
| title | Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy |
| title_full | Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy |
| title_fullStr | Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy |
| title_full_unstemmed | Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy |
| title_short | Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy |
| title_sort | endoscopic septotomy as a treatment for leaks after sleeve gastrectomy |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/a-1027-6888 |
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