Skip to main content
Top
Published in: Obesity Surgery 3/2014

01-03-2014 | Brief Communication

‘Stent in a Stent’—An Alternative Technique for Removing Partially Covered Stents Following Sleeve Gastrectomy Complications

Authors: Georgios Vasilikostas, Nimalan Sanmugalingam, Omar Khan, Marcus Reddy, Chris Groves, Andrew Wan

Published in: Obesity Surgery | Issue 3/2014

Login to get access

Abstract

Endoscopic stenting is a relatively new technique for the treatment of post sleeve gastrectomy complications. Partially covered stents are used in this method to minimise the risk of migration but they are associated with difficulties with removal. Patients requiring emergency stenting following sleeve gastrectomy underwent insertion of a partially covered metallic stent. One month later, if the stent was not easily removable, a fully covered overlapping stent was inserted and the patient was readmitted 2 weeks later for removal of both stents. Four patients required stenting following sleeve gastrectomy leaks, and one patient required stenting for a stricture. In these cases, a ‘stent in a stent’ technique was used for removal. This technique allows the safe removal of partially covered stents inserted following sleeve gastrectomy complications.
Literature
1.
go back to reference Glashysher M, Khan OA, Mabuure NT, et al. Staple line reinforcement during laparoscopic sleeve gastrectomy: does it affect clinical outcomes? Int J Surg. 2013;11(4):286–9.CrossRef Glashysher M, Khan OA, Mabuure NT, et al. Staple line reinforcement during laparoscopic sleeve gastrectomy: does it affect clinical outcomes? Int J Surg. 2013;11(4):286–9.CrossRef
2.
go back to reference Serra C, Baltasar A, Andreo L, et al. Treatment of gastric leaks with coasted self-expanding stents after sleeve gastrectomy. Obes Surg. 2007;17:866–72.PubMedCrossRef Serra C, Baltasar A, Andreo L, et al. Treatment of gastric leaks with coasted self-expanding stents after sleeve gastrectomy. Obes Surg. 2007;17:866–72.PubMedCrossRef
3.
go back to reference Nguyen NT, Nguyen X-M T, Dholakia C. The use of endoscopic stent in management of leaks after sleeve gastrectomy. Obes Surg. 2010;20:1289–92.PubMedCrossRef Nguyen NT, Nguyen X-M T, Dholakia C. The use of endoscopic stent in management of leaks after sleeve gastrectomy. Obes Surg. 2010;20:1289–92.PubMedCrossRef
4.
go back to reference Simon F, Siciliano I, Gillet A, et al. Gastric leak after laparoscopic sleeve gastrectomy: early covered self-expandable stent reduces healing time. Obes Surg. 2013;23(5):687–92.PubMedCrossRef Simon F, Siciliano I, Gillet A, et al. Gastric leak after laparoscopic sleeve gastrectomy: early covered self-expandable stent reduces healing time. Obes Surg. 2013;23(5):687–92.PubMedCrossRef
5.
go back to reference Eubanks S, Edwards CA, Fearing NM, et al. Use of endoscopic stents to treat anatomotic complications after bariatric surgery. J Am Coll Surg. 2008;206:935–8.PubMedCrossRef Eubanks S, Edwards CA, Fearing NM, et al. Use of endoscopic stents to treat anatomotic complications after bariatric surgery. J Am Coll Surg. 2008;206:935–8.PubMedCrossRef
6.
go back to reference Fukumoto R, Orlina J, McGinty J, et al. Use of polyflex stents in treatment of acute oesophageal and gastric leaks after bariatric surgery. Surg Obes Relat Dis. 2007;3:68–72.PubMedCrossRef Fukumoto R, Orlina J, McGinty J, et al. Use of polyflex stents in treatment of acute oesophageal and gastric leaks after bariatric surgery. Surg Obes Relat Dis. 2007;3:68–72.PubMedCrossRef
7.
go back to reference Efthimiou E, Stein L, Szego P, et al. Stent migration causing alimentary limb obstruction necessitating laparotomy and surgical stent extraction. Surg Obes Relat Dis. 2009;5:375–7.PubMedCrossRef Efthimiou E, Stein L, Szego P, et al. Stent migration causing alimentary limb obstruction necessitating laparotomy and surgical stent extraction. Surg Obes Relat Dis. 2009;5:375–7.PubMedCrossRef
8.
go back to reference Swinnen J, Eisendrath P, Rigaux J, et al. Self-expandable metal stents for the treatment of benign upper GI leaks and perforations. Gastrointest Endosc. 2011;73(5):890–9. Swinnen J, Eisendrath P, Rigaux J, et al. Self-expandable metal stents for the treatment of benign upper GI leaks and perforations. Gastrointest Endosc. 2011;73(5):890–9.
9.
go back to reference Puli SR, Spofford IS, Thompson CC. Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis. Clin Endosc. 2012;75:287–92. Puli SR, Spofford IS, Thompson CC. Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis. Clin Endosc. 2012;75:287–92.
10.
go back to reference Van Boeckel PGA, Sijbring A, Vleggaar FP, et al. Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus. Aliment Pharmacol Ther. 2011;33:1292–301.PubMedCrossRef Van Boeckel PGA, Sijbring A, Vleggaar FP, et al. Systematic review: temporary stent placement for benign rupture or anastomotic leak of the oesophagus. Aliment Pharmacol Ther. 2011;33:1292–301.PubMedCrossRef
11.
go back to reference Yehoshua RT, Eidelman LA, Stein M, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18:1083–8.PubMedCrossRef Yehoshua RT, Eidelman LA, Stein M, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18:1083–8.PubMedCrossRef
12.
go back to reference Wei W, Ramaswamy A, de la Torre R, et al. Partially covered esophageal stents cause bowel injury when used to treat complications of bariatric surgery. Surg Endosc. 2013;27:56–60.PubMedCrossRef Wei W, Ramaswamy A, de la Torre R, et al. Partially covered esophageal stents cause bowel injury when used to treat complications of bariatric surgery. Surg Endosc. 2013;27:56–60.PubMedCrossRef
13.
go back to reference Hirdes MM, Siersema PD, Houben MHMG, et al. Stent-in-stent technique for removal of embedded esophageal self-expanding metal stents. Am J Gastro-Enterol. 2011;106:286–93.CrossRef Hirdes MM, Siersema PD, Houben MHMG, et al. Stent-in-stent technique for removal of embedded esophageal self-expanding metal stents. Am J Gastro-Enterol. 2011;106:286–93.CrossRef
14.
go back to reference Mayoral W, Fleischer D, Salcedo J, et al. Nonmalignant obstruction is a common problem with metal stents in the treatment of oesophageal cancer. Gastrointest Endosc. 2000;51:556–9.PubMedCrossRef Mayoral W, Fleischer D, Salcedo J, et al. Nonmalignant obstruction is a common problem with metal stents in the treatment of oesophageal cancer. Gastrointest Endosc. 2000;51:556–9.PubMedCrossRef
15.
go back to reference Eisendrath P, Cremer M, Himpens J, et al. Endotherapy including temporary stenting of fistulas of the upper gastrointestinal tract after laparoscopic bariatric surgery. Endoscopy. 2007;39:625–30.PubMedCrossRef Eisendrath P, Cremer M, Himpens J, et al. Endotherapy including temporary stenting of fistulas of the upper gastrointestinal tract after laparoscopic bariatric surgery. Endoscopy. 2007;39:625–30.PubMedCrossRef
16.
go back to reference Siersema PD, Homs MY, Haringsma J, et al. Use of a large-diameter metallic stents to seal traumatic non-malignant perforations of the oesophagus. Gastrointest Endosc. 2003;58:356–61.PubMedCrossRef Siersema PD, Homs MY, Haringsma J, et al. Use of a large-diameter metallic stents to seal traumatic non-malignant perforations of the oesophagus. Gastrointest Endosc. 2003;58:356–61.PubMedCrossRef
17.
go back to reference Langer FB, Schoppmann SF, Prager G, et al. Solving the problem of difficult stent removal due to tissue ingrowth in partially uncovered esophageal self-expanding metal stents. Ann Thorac Surg. 2010;89:1691–2.PubMedCrossRef Langer FB, Schoppmann SF, Prager G, et al. Solving the problem of difficult stent removal due to tissue ingrowth in partially uncovered esophageal self-expanding metal stents. Ann Thorac Surg. 2010;89:1691–2.PubMedCrossRef
18.
go back to reference Vlavianos P, Zabron A. Clinical outcomes, quality of life, advantages and disadvantages of metal stent placement in the upper gastrointestinal tract. Curr Opin Support Palliat Care. 2012;6:27–32.PubMedCrossRef Vlavianos P, Zabron A. Clinical outcomes, quality of life, advantages and disadvantages of metal stent placement in the upper gastrointestinal tract. Curr Opin Support Palliat Care. 2012;6:27–32.PubMedCrossRef
Metadata
Title
‘Stent in a Stent’—An Alternative Technique for Removing Partially Covered Stents Following Sleeve Gastrectomy Complications
Authors
Georgios Vasilikostas
Nimalan Sanmugalingam
Omar Khan
Marcus Reddy
Chris Groves
Andrew Wan
Publication date
01-03-2014
Publisher
Springer US
Published in
Obesity Surgery / Issue 3/2014
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-013-1163-0

Other articles of this Issue 3/2014

Obesity Surgery 3/2014 Go to the issue