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Open Access 01-03-2021 | Sleeve Gastrectomy

Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis

Authors: Pawel Rogalski, Agnieszka Swidnicka-Siergiejko, Justyna Wasielica-Berger, Damian Zienkiewicz, Barbara Wieckowska, Eugeniusz Wroblewski, Andrzej Baniukiewicz, Magdalena Rogalska-Plonska, Grzegorz Siergiejko, Andrzej Dabrowski, Jaroslaw Daniluk

Published in: Surgical Endoscopy | Issue 3/2021

Abstract

Background

Endoscopic techniques have become the first-line therapy in bariatric surgery-related complications such as leaks and fistulas. We performed a systematic review and meta-analysis on the effectiveness of self-expandable stents, clipping, and tissue sealants in closing of post-bariatric surgery leak/fistula.

Methods

A systematic literature search of the Medline/Scopus databases was performed to identify full-text articles published up to February 2019 on the use of self-expandable stents, clipping, or tissue sealants as primary endoscopic strategies used for leak/fistula closure. Meta-analysis of studies reporting stents was performed with the PRISMA guidelines.

Results

Data concerning the efficacy of self-expanding stents in the treatment of leaks/fistulas after bariatric surgery were extracted from 40 studies (493 patients). The overall proportion of successful leak/fistula closure was 92% (95% CI, 90–95%). The overall proportion of stent migration was 23% (95% CI, 19–28%). Seventeen papers (98 patients) reported the use of clipping: the over-the-scope clips (OTSC) system was used in 85 patients with a successful closure rate of 67.1% and a few complications (migration, stenosis, tear). The successful fistula/leak closure using other than OTSC types was achieved in 69.2% of patients. In 10 case series (63 patients), fibrin glue alone was used with a 92.8–100% success rate of fistula closure that usually required repeated sessions at scheduled intervals. The complications of fibrin glue applications were reported in only one study and included pain and fever in 12.5% of patients.

Conclusions

Endoscopic techniques are effective for management of post-bariatric leaks and fistulas in properly selected patients.

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Hady R, Luba M, Czerniawski M, Wojciak P, Diemieszczyk I, Pawluszewicz P et al (2018) Progress in bariatric-metabolic surgery. Post N Med XXXI:106–113

Disorders IFftSoOaM (2018) Bariatric Surgery. https://www.ifso.com/bariatric-surgery/. Accessed 2 Feb 2019

Committee ASfMaBSCI (2011) American Society for metabolic and bariatric surgery position statement on global bariatric healthcare. Surg Obes Relat Dis 7(6):669–671CrossRef

(AHRQ) AfHRaQ (2007) Statistical Brief #23. Bariatric Surgery Utilization and Outcomes in 1998 and 2004. https://www.hcup-us.ahrq.gov/reports/statbriefs/sb23.jsp. Accessed 2 Feb 2019

Ma IT, Madura JA (2015) Gastrointestinal Complications After Bariatric Surgery. Gastroenterol Hepatol (N Y) 11(8):526–535

Rosenthal RJ, Diaz AA, Arvidsson D, Baker RS, Basso N, Bellanger D et al (2012) International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of %3e12,000 cases. Surg Obes Relat Dis 8(1):8–19PubMedCrossRef

Hady R, Czerniawski M, Luba M, Swidnicka-Siergiejko A, Baniukiewicz A, Dadan J et al (2018) Gastric fistula and its treatment after sleeve gastrectomy in patients after kidney transplantation—a case report. Post N Med XXXI:89–91

Carucci LR, Turner MA, Conklin RC, DeMaria EJ, Kellum JM, Sugerman HJ (2006) Roux-en-Y gastric bypass surgery for morbid obesity: evaluation of postoperative extraluminal leaks with upper gastrointestinal series. Radiology 238(1):119–127PubMedCrossRef

Blachar A, Federle MP, Pealer KM, Ikramuddin S, Schauer PR (2002) Gastrointestinal complications of laparoscopic Roux-en-Y gastric bypass surgery: clinical and imaging findings. Radiology 223(3):625–632PubMedCrossRef

10.

Shehab HM, Elasmar HM (2013) Combined endoscopic techniques for closure of a chronic post-surgical gastrocutaneous fistula: case report and review of the literature (with video). Surg Endosc 27(8):2967–2970PubMedCrossRef

11.

Rogalski P, Daniluk J, Baniukiewicz A, Wroblewski E, Dabrowski A (2015) Endoscopic management of gastrointestinal perforations, leaks and fistulas. World J Gastroenterol 21(37):10542–10552PubMedPubMedCentralCrossRef

12.

Rogalski P, Hady HR, Baniukiewicz A, Dąbrowski A, Kaminski F, Dadan J (2012) Gastric band migration following laparoscopic adjustable gastric banding (LAGB): two cases of endoscopic management using a gastric band cutter. Wideochir Inne Tech Malo Inwazyjne 7(2):114–117PubMed

13.

Puli SR, Spofford IS, Thompson CC (2012) Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis. Gastrointest Endosc 75(2):287–293PubMedCrossRef

14.

Okazaki O, Bernardo WM, Brunaldi VO, Junior CCC, Minata MK, de Moura DTH et al (2018) Efficacy and safety of stents in the treatment of fistula after bariatric surgery: a systematic review and meta-analysis. Obes Surg 28(6):1788–1796PubMedCrossRef

15.

Shoar S, Poliakin L, Khorgami Z, Rubenstein R, El-Matbouly M, Levin JL et al (2017) Efficacy and safety of the over-the-scope clip (OTSC) system in the management of leak and fistula after laparoscopic sleeve gastrectomy: a systematic review. Obes Surg 27(9):2410–2418PubMedCrossRef

16.

Higgins J, Green S (2008) Cochrane handbook for systematic reviews of interventions. Wiley, OxfordCrossRef

17.

Bruce J, Krukowski ZH, Al-Khairy G, Russell EM, Park KG (2001) Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg 88(9):1157–1168PubMedCrossRef

18.

DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7(3):177–188CrossRefPubMed

19.

Newcombe RG (1998) Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 17(8):857–872PubMedCrossRef

20.

Begg CB, Mazumdar M (1994) Operating characteristics of a rank correlation test for publication bias. Biometrics 50(4):1088–1101PubMedCrossRef

21.

Salinas A, Baptista A, Santiago E, Antor M, Salinas H (2006) Self-expandable metal stents to treat gastric leaks. Surg Obes Relat Dis 2(5):570–572PubMedCrossRef

22.

Campos JM, Pereira EF, Evangelista LF, Siqueira L, Neto MG, Dib V et al (2011) Gastrobronchial fistula after sleeve gastrectomy and gastric bypass: endoscopic management and prevention. Obes Surg 21(10):1520–1529PubMedCrossRef

23.

Vix M, Diana M, Marx L, Callari C, Wu HS, Perretta S et al (2015) Management of staple line leaks after sleeve gastrectomy in a consecutive series of 378 patients. Surg Laparosc Endosc Percutan Tech 25(1):89–93PubMedCrossRef

24.

Eisendrath P, Cremer M, Himpens J, Cadière GB, Le Moine O, Devière J (2007) Endotherapy including temporary stenting of fistulas of the upper gastrointestinal tract after laparoscopic bariatric surgery. Endoscopy 39(7):625–630PubMedCrossRef

25.

Fukumoto R, Orlina J, McGinty J, Teixeira J (2007) Use of Polyflex stents in treatment of acute esophageal and gastric leaks after bariatric surgery. Surg Obes Relat Dis 3(1):68–71 discussion 2PubMedCrossRef

26.

Edwards CA, Bui TP, Astudillo JA, de la Torre RA, Miedema BW, Ramaswamy A et al (2008) Management of anastomotic leaks after Roux-en-Y bypass using self-expanding polyester stents. Surg Obes Relat Dis 4(5):594–599 discussion 9–600PubMedCrossRef

27.

Yimcharoen P, Heneghan HM, Tariq N, Brethauer SA, Kroh M, Chand B (2011) Endoscopic stent management of leaks and anastomotic strictures after foregut surgery. Surg Obes Relat Dis 7(5):628–636PubMedCrossRef

28.

Corona M, Zini C, Allegritti M, Boatta E, Lucatelli P, Cannavale A et al (2013) Minimally invasive treatment of gastric leak after sleeve gastrectomy. Radiol Med 118(6):962–970PubMedCrossRef

29.

Klimczak T, Klimczak J, Szewczyk T, Janczak P, Jurałowicz P (2018) Endoscopic treatment of leaks after laparoscopic sleeve gastrectomy using MEGA esophageal covered stents. Surg Endosc 32(4):2038–2045PubMedCrossRef

30.

Tsai YN, Wang HP, Huang CK, Chang PC, Lin IC, Tai CM (2018) Endoluminal stenting for the management of leak following sleeve gastrectomy and loop duodenojejunal bypass with sleeve gastrectomy. Kaohsiung J Med Sci 34(1):43–48PubMedCrossRef

31.

Matłok M, Major P, Pędziwiatr M, Winiarski M, Budzyński P, Małczak P et al (2015) Endoscopic insertion of a self-expandable stent combined with laparoscopic rinsing of peritoneal cavity as a method for staple line leaks treatment in patients post laparoscopic sleeve gastrectomy. Pol Przegl Chir 87(5):238–244PubMedCrossRef

32.

Périssé LG, Périssé PC, Bernardo JC (2015) Endoscopic treatment of the fistulas after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass. Rev Col Bras Cir 42(3):159–164PubMedCrossRef

33.

Galloro G, Magno L, Musella M, Manta R, Zullo A, Forestieri P (2014) A novel dedicated endoscopic stent for staple-line leaks after laparoscopic sleeve gastrectomy: a case series. Surg Obes Relat Dis 10(4):607–611PubMedCrossRef

34.

Alazmi W, Al-Sabah S, Ali DA, Almazeedi S (2014) Treating sleeve gastrectomy leak with endoscopic stenting: the Kuwaiti experience and review of recent literature. Surg Endosc 28(12):3425–3428PubMedCrossRef

35.

van den Berg MW, Kerbert AC, van Soest EJ, Schwartz MP, Bakker CM, Gilissen LP et al (2016) Safety and efficacy of a fully covered large-diameter self-expanding metal stent for the treatment of upper gastrointestinal perforations, anastomotic leaks, and fistula. Dis Esophagus 29(6):572–579PubMedCrossRef

36.

van Wezenbeek MR, de Milliano MM, Nienhuijs SW, Friederich P, Gilissen LP (2016) A Specifically designed stent for anastomotic leaks after bariatric surgery: experiences in a tertiary referral hospital. Obes Surg 26(8):1875–1880PubMedCrossRef

37.

Al Lehibi A, Al Balkhi A, Al Mtawa A, Al ON (2018) Endoscopic biodegradable stents as a rescue treatment in the management of post bariatric surgery leaks: a case series. Endosc Int Open 6(6):E722–E726PubMedPubMedCentralCrossRef

38.

Almadi MA, Bamihriz F, Alharbi O, Azzam N, Aljammaz A, Eltayeb M et al (2018) Use of self-expandable metal stents in the treatment of leaks complicating laparoscopic sleeve gastrectomy: a cohort study. Obes Surg 28(6):1562–1570PubMedCrossRef

39.

Emre A, Sertkaya M, Akbulut S, Erbil O, Yurttutan N, Kale İ et al (2018) Self-expandable metallic stent application for the management of upper gastrointestinal tract disease. Turk J Surg 34(2):101–105PubMedPubMedCentralCrossRef

40.

Garofalo F, Noreau-Nguyen M, Denis R, Atlas H, Garneau P, Pescarus R (2017) Evolution of endoscopic treatment of sleeve gastrectomy leaks: from partially covered to long, fully covered stents. Surg Obes Relat Dis 13(6):925–932PubMedCrossRef

41.

Tringali A, Bove V, Perri V, Landi R, Familiari P, Boškoski I et al (2017) Endoscopic treatment of post-laparoscopic sleeve gastrectomy leaks using a specifically designed metal stent. Endoscopy 49(1):64–68PubMed

42.

Montuori M, Benavoli D, D'Ugo S, Di Benedetto L, Bianciardi E, Gaspari AL et al (2017) Integrated approaches for the management of staple line leaks following sleeve gastrectomy. J Obes 2017:4703236PubMedPubMedCentralCrossRef

43.

Quezada N, Maiz C, Daroch D, Funke R, Sharp A, Boza C et al (2015) Effect of early use of covered self-expandable endoscopic stent on the treatment of postoperative stapler line leaks. Obes Surg 25(10):1816–1821PubMedCrossRef

44.

Aras A, Oran E, Bozkurt MA, Halıcıoglu i, Alış H (2014) Successful treatment of post-sleeve gastric leak with an uncovered biodegradable stent. Acta Endosc 44(6):382–384CrossRef

45.

Leenders BJ, Stronkhorst A, Smulders FJ, Nieuwenhuijzen GA, Gilissen LP (2013) Removable and repositionable covered metal self-expandable stents for leaks after upper gastrointestinal surgery: experiences in a tertiary referral hospital. Surg Endosc 27(8):2751–2759PubMedCrossRef

46.

Marr B, Needleman B, Mikami D (2012) Endoscopic Stenting for Treatment of Leaks Following Sleeve Gastrectomy. World J Laparosc Surg 5(3):139–142CrossRef

47.

Krishnan V, Hutchings K, Godwin A, Wong JT, Teixeira J (2019) Long-term outcomes following endoscopic stenting in the management of leaks after foregut and bariatric surgery. Surg Endosc 33(8):2691–2695PubMedCrossRef

48.

Boerlage TCC, Houben GPM, Groenen MJM, van der Linde K, van de Laar AWJM, Emous M et al (2018) A novel fully covered double-bump stent for staple line leaks after bariatric surgery: a retrospective analysis. Surg Endosc 32(7):3174–3180PubMedPubMedCentralCrossRef

49.

El-Sayes IA, Frenken M, Weiner RA (2017) Management of leakage and stenosis after sleeve gastrectomy. Surgery 162(3):652–661PubMedCrossRef

50.

Aydın MT, Alahdab Y, Aras O, Karip B, Onur E, İşcan Y et al (2016) Endoscopic stenting for laparoscopic sleeve gastrectomy leaks. Ulus Cerrahi Derg 32(4):275–280PubMedPubMedCentral

51.

Rebibo L, Hakim S, Brazier F, Dhahri A, Cosse C, Regimbeau JM (2016) New endoscopic technique for the treatment of large gastric fistula or gastric stenosis associated with gastric leaks after sleeve gastrectomy. Surg Obes Relat Dis 12(8):1577–1584PubMedCrossRef

52.

Fishman S, Shnell M, Gluck N, Meirsdorf S, Abu-Abeid S, Santo E (2015) Use of sleeve-customized self-expandable metal stents for the treatment of staple-line leakage after laparoscopic sleeve gastrectomy. Gastrointest Endosc 81(5):1291–1294PubMedCrossRef

53.

Moon RC, Shah N, Teixeira AF, Jawad MA (2015) Management of staple line leaks following sleeve gastrectomy. Surg Obes Relat Dis 11(1):54–59PubMedCrossRef

54.

Freedman J, Jonas E, Näslund E, Nilsson H, Marsk R, Stockeld D (2013) Treatment of leaking gastrojejunostomy after gastric bypass surgery with special emphasis on stenting. Surg Obes Relat Dis 9(4):554–558PubMedCrossRef

55.

Simon F, Siciliano I, Gillet A, Castel B, Coffin B, Msika S (2013) Gastric leak after laparoscopic sleeve gastrectomy: early covered self-expandable stent reduces healing time. Obes Surg 23(5):687–692PubMedCrossRef

56.

Inbar R, Santo E, Al-A S, Korianski J, Halperin Z, Greenberg R et al (2011) Insertion of removable self-expanding metal stents as a treatment for postoperative leaks and perforations of the esophagus and stomach. Isr Med Assoc J 13(4):230–233PubMed

57.

Tan JT, Kariyawasam S, Wijeratne T, Chandraratna HS (2010) Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 20(4):403–409PubMedCrossRef

58.

Blackmon SH, Santora R, Schwarz P, Barroso A, Dunkin BJ (2010) Utility of removable esophageal covered self-expanding metal stents for leak and fistula management. Ann Thorac Surg 89(3):931–936 discussion 6–7PubMedCrossRef

59.

Nguyen NT, Nguyen XM, Dholakia C (2010) The use of endoscopic stent in management of leaks after sleeve gastrectomy. Obes Surg 20(9):1289–1292PubMedCrossRef

60.

Casella G, Soricelli E, Rizzello M, Trentino P, Fiocca F, Fantini A et al (2009) Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obes Surg 19(7):821–826PubMedCrossRef

61.

de Aretxabala X, Leon J, Wiedmaier G, Turu I, Ovalle C, Maluenda F et al (2011) Gastric leak after sleeve gastrectomy: analysis of its management. Obes Surg 21(8):1232–1237PubMedCrossRef

62.

Tan JJ, Tjandra JJ (2006) Which is the optimal bowel preparation for colonoscopy—a meta-analysis. Colorectal Dis 8(4):247–258PubMedCrossRef

63.

Tsai CF, Chu CJ, Huang YH, Wang YP, Liu PY, Lin HC et al (2015) Detecting minimal hepatic encephalopathy in an endemic country for hepatitis B: the role of psychometrics and serum IL-6. PLoS ONE 10(6):e0128437PubMedPubMedCentralCrossRef

64.

Tabibian JH, Kochman ML (2017) Over-the-wire technique to facilitate over-the-scope clip closure of fistulae. Gastrointest Endosc 85(2):454–455PubMedCrossRef

65.

Caballero Y, López-Tomassetti E, Castellot A, Hernández JR (2016) Endoscopic management of a gastric leak after laparoscopic sleeve gastrectomy using the over-the-scope-clip (Ovesco®) system. Rev Esp Enferm Dig 108(11):746–750PubMed

66.

Donatelli G, Ferretti S, Vergeau BM, Dhumane P, Dumont JL, Derhy S et al (2014) Endoscopic Internal Drainage with Enteral Nutrition (EDEN) for treatment of leaks following sleeve gastrectomy. Obes Surg 24(8):1400–1407PubMedCrossRef

67.

Aly A, Lim HK (2013) The use of over the scope clip (OTSC) device for sleeve gastrectomy leak. J Gastrointest Surg 17(3):606–608PubMedCrossRef

68.

Ritter LA, Wang AY, Sauer BG, Kleiner DE (2013) Healing of complicated gastric leaks in bariatric patients using endoscopic clips. JSLS 17(3):481–483PubMedPubMedCentralCrossRef

69.

Iacopini F, Di Lorenzo N, Altorio F, Schurr MO, Scozzarro A (2010) Over-the-scope clip closure of two chronic fistulas after gastric band penetration. World J Gastroenterol 16(13):1665–1669PubMedPubMedCentralCrossRef

70.

Merrifield BF, Lautz D, Thompson CC (2006) Endoscopic repair of gastric leaks after Roux-en-Y gastric bypass: a less invasive approach. Gastrointest Endosc 63(4):710–714PubMedCrossRef

71.

Lee HL, Cho JY, Cho JH, Park JJ, Kim CG, Kim SH et al (2018) Efficacy of the over-the-scope clip system for treatment of gastrointestinal fistulas, leaks, and perforations: a Korean Multi-Center Study. Clin Endosc 51(1):61–65PubMedCrossRef

72.

Benosman H, Rahmi G, Perrod G, Bruzzi M, Samaha E, Vienne A et al (2018) Endoscopic management of post-bariatric surgery fistula: a tertiary care center experience. Obes Surg 28(12):3910–3915PubMedCrossRef

73.

Kim SY, Oh KY, Chung JW, Kim YJ, Kim KO, Kwon KA et al (2017) Endoscopic treatment of diverse complications caused by laparoscopic adjustable gastric banding: a study in Eastern Asia. Gut Liver 11(4):497–503PubMedPubMedCentralCrossRef

74.

Niland B, Brock A (2017) Over-the-scope clip for endoscopic closure of gastrogastric fistulae. Surg Obes Relat Dis 13(1):15–20PubMedCrossRef

75.

Keren D, Eyal O, Sroka G, Rainis T, Raziel A, Sakran N et al (2015) Over-the-scope clip (OTSC) system for sleeve gastrectomy leaks. Obes Surg 25(8):1358–1363PubMedCrossRef

76.

Law R, Wong Kee Song LM, Irani S, Baron TH (2015) Immediate technical and delayed clinical outcome of fistula closure using an over-the-scope clip device. Surg Endosc 29(7):1781–1786PubMedCrossRef

77.

Mercky P, Gonzalez JM, Aimore Bonin E, Emungania O, Brunet J, Grimaud JC et al (2015) Usefulness of over-the-scope clipping system for closing digestive fistulas. Dig Endosc 27(1):18–24PubMedCrossRef

78.

Aburajab MA, Max JB, Ona MA, Gupta K, Burch M, Michael Feiz F et al (2017) Covered esophageal stenting is effective for symptomatic gastric lumen narrowing and related complications following laparoscopic sleeve gastrectomy. Dig Dis Sci 62(11):3077–3083PubMedCrossRef

79.

Bhardwaj A, Cooney RN, Wehrman A, Rogers AM, Mathew A (2010) Endoscopic repair of small symptomatic gastrogastric fistulas after gastric bypass surgery: a single center experience. Obes Surg 20(8):1090–1095PubMedCrossRef

80.

Surace M, Mercky P, Demarquay JF, Gonzalez JM, Dumas R, Ah-Soune P et al (2011) Endoscopic management of GI fistulae with the over-the-scope clip system (with video). Gastrointest Endosc 74(6):1416–1419PubMedCrossRef

81.

Anastasiou J, Hussameddin A, Al QA (2017) Mind the gap: successful endoscopic closure of a large gastric sleeve leak using an endoscopic stent and over-the-scope clips. Case Rep Gastroenterol 11(3):763–768PubMedPubMedCentralCrossRef

82.

Christophorou D, Valats JC, Funakoshi N, Duflos C, Picot MC, Vedrenne B et al (2015) Endoscopic treatment of fistula after sleeve gastrectomy: results of a multicenter retrospective study. Endoscopy 47(11):988–996PubMedCrossRef

83.

Lorenzo D, Guilbaud T, Gonzalez JM, Benezech A, Dutour A, Boullu S et al (2018) Endoscopic treatment of fistulas after sleeve gastrectomy: a comparison of internal drainage versus closure. Gastrointest Endosc 87(2):429–437PubMedCrossRef

84.

Shehab H, Abdallah E, Gawdat K, Elattar I (2018) Large bariatric-specific stents and over-the-scope clips in the management of post-bariatric surgery leaks. Obes Surg 28(1):15–24PubMedCrossRef

85.

Aranez J, Singh A, Bain A (2015) Endoscopic closure of a gastric sleeve leak by using an over-the-scope clip and fully covered esophageal stent. Gastrointest Endosc 82(2):404PubMedCrossRef

86.

Fernandez AZ, Luthra AK, Evans JA (2015) Endoscopic closure of persistent gastric leak and fistula following laparoscopic sleeve gastrectomy. Int J Surg Case Rep 6C:186–187PubMedCrossRef

87.

Gómez V, Lukens FJ, Woodward TA (2013) Closure of an iatrogenic bariatric gastric fistula with an over-the-scope clip. Surg Obes Relat Dis 9(2):e31–e33PubMedCrossRef

88.

Schiesser M, Kressig P, Bueter M, Nocito A, Bauerfeind P, Gubler C (2014) Successful endoscopic management of gastrointestinal leakages after laparoscopic Roux-en-Y gastric bypass surgery. Dig Surg 31(1):67–70PubMedCrossRef

89.

Conio M, Blanchi S, Repici A, Bastardini R, Marinari GM (2010) Use of an over-the-scope clip for endoscopic sealing of a gastric fistula after sleeve gastrectomy. Endoscopy 42(Suppl 2):E71–E72PubMedCrossRef

90.

Evans JA, Branch MS, Pryor AD, Demaria EJ (2007) Endoscopic closure of a gastrojejunal anastomotic leak (with video). Gastrointest Endosc 66(6):1225–1226 discussion 6PubMedCrossRef

91.

Fernandez-Esparrach G, Lautz DB, Thompson CC (2010) Endoscopic repair of gastrogastric fistula after Roux-en-Y gastric bypass: a less-invasive approach. Surg Obes Relat Dis 6(3):282–288PubMedCrossRef

92.

Papavramidis ST, Eleftheriadis EE, Apostolidis DN, Kotzampassi KE (2001) Endoscopic fibrin sealing of high-output non-healing gastrocutaneous fistulas after vertical gastroplasty in morbidly obese patients. Obes Surg 11(6):766–769PubMedCrossRef

93.

Garcia-Caballero M, Carbajo M, Martinez-Moreno JM, Sarria M, Osorio D, Carmona JA (2005) Drain erosion and gastro-jejunal fistula after one-anastomosis gastric bypass: endoscopic occlusion by fibrin sealant. Obes Surg 15(5):719–722PubMedCrossRef

94.

Papavramidis TS, Kotzampassi K, Kotidis E, Eleftheriadis EE, Papavramidis ST (2008) Endoscopic fibrin sealing of gastrocutaneous fistulas after sleeve gastrectomy and biliopancreatic diversion with duodenal switch. J Gastroenterol Hepatol 23(12):1802–1805PubMedCrossRef

95.

Kotzampassi K, Eleftheriadis E (2015) Tissue sealants in endoscopic applications for anastomotic leakage during a 25-year period. Surgery 157(1):79–86PubMedCrossRef

96.

Brolin RE, Lin JM (2013) Treatment of gastric leaks after Roux-en-Y gastric bypass: a paradigm shift. Surg Obes Relat Dis 9(2):229–233PubMedCrossRef

97.

Ece I, Yilmaz H, Alptekin H, Acar F, Yormaz S, Sahin M (2015) Minimally invasive management of anastomotic leak after bariatric Roux-en-Y gastric bypass. J Minim Access Surg 11(2):160–162PubMedPubMedCentralCrossRef

98.

Assalia A, Ilivitzki A, Ofer A, Suissa A, Manassa E, Khamaysi I et al (2018) Management of gastric fistula complicating laparoscopic sleeve gastrectomy with biological glue in a combined percutaneous and endoscopic approach. Surg Obes Relat Dis 14(8):1093–1098PubMedCrossRef

99.

Maluf-Filho F, Hondo F, Halwan B, de Lima MS, Giordano-Nappi JH, Sakai P (2009) Endoscopic treatment of Roux-en-Y gastric bypass-related gastrocutaneous fistulas using a novel biomaterial. Surg Endosc 23(7):1541–1545PubMedCrossRef

100.

Papavramidis ST, Eleftheriadis EE, Papavramidis TS, Kotzampassi KE, Gamvros OG (2004) Endoscopic management of gastrocutaneous fistula after bariatric surgery by using a fibrin sealant. Gastrointest Endosc 59(2):296–300PubMedCrossRef

101.

Kowalski C, Kastuar S, Mehta V, Brolin RE (2007) Endoscopic injection of fibrin sealant in repair of gastrojejunostomy leak after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis 3(4):438–442PubMedCrossRef

102.

Bonanomi G, Prince JM, McSteen F, Schauer PR, Hamad GG (2004) Sealing effect of fibrin glue on the healing of gastrointestinal anastomoses: implications for the endoscopic treatment of leaks. Surg Endosc 18(11):1620–1624PubMed

103.

Liu CD, Glantz GJ, Livingston EH (2003) Fibrin glue as a sealant for high-risk anastomosis in surgery for morbid obesity. Obes Surg 13(1):45–48PubMedCrossRef

104.

Vilallonga R, Himpens J, Bosch B, van de Vrande S, Bafort J (2016) Role of percutaneous glue treatment after persisting leak after laparoscopic sleeve gastrectomy. Obes Surg 26(7):1378–1383PubMedCrossRef

105.

Cosse C, Rebibo L, Brazier F, Hakim S, Delcenserie R, Regimbeau JM (2018) Cost-effectiveness analysis of stent type in endoscopic treatment of gastric leak after laparoscopic sleeve gastrectomy. Br J Surg 105(5):570–577PubMedCrossRef

106.

Southwell T, Lim TH, Ogra R (2016) Endoscopic therapy for treatment of staple line leaks post-laparoscopic sleeve gastrectomy (LSG): experience from a large Bariatric Surgery Centre in New Zealand. Obes Surg 26(6):1155–1162PubMedCrossRef

107.

Murino A, Arvanitakis M, Le Moine O, Blero D, Devière J, Eisendrath P (2015) Effectiveness of endoscopic management using self-expandable metal stents in a large cohort of patients with post-bariatric leaks. Obes Surg 25(9):1569–1576PubMedCrossRef

Title: Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis
Authors: Pawel Rogalski
Agnieszka Swidnicka-Siergiejko
Justyna Wasielica-Berger
Damian Zienkiewicz
Barbara Wieckowska
Eugeniusz Wroblewski
Andrzej Baniukiewicz
Magdalena Rogalska-Plonska
Grzegorz Siergiejko
Andrzej Dabrowski
Jaroslaw Daniluk
Publication date: 01-03-2021
Publisher: Springer US
Keywords: Sleeve Gastrectomy
Bariatric Surgery
Bariatric Surgery
Published in: Surgical Endoscopy / Issue 3/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07471-1

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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Effect of dynamic position changes during colonoscope withdrawal: a meta-analysis of randomized controlled trials

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Aggressive hydration compared to standard hydration with lactated ringer’s solution for prevention of post endoscopic retrograde cholangiopancreatography pancreatitis

Endoscopic resection reduces morbidity when compared to surgery in veterans with large and complex colorectal polyps

Insight into the methodology and uptake of EAES guidelines: a qualitative analysis and survey by the EAES Consensus & Guideline Subcommittee