| Gastrobronchial fistula after sleeve gastrectomy and gastric bypass: endoscopic management and prevention. | |
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MedLine Citation:
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PMID: 21643779 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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Gastrobronchial fistula (GBF) is a serious complication following bariatric surgery, whose treatment by thoracotomy and/or laparotomy involves a high morbidity rate. We present the outcomes of endoscopic management for GBF as a helpful technique for its healing process. This is a multicenter retrospective study of 15 patients who underwent gastric bypass (n = 10) and sleeve gastrectomy (n = 5) and presented GBF postoperatively (mean of 6.7 months). Ten patients developed lung abscess and were treated by antibiotic therapy (n = 10) and thoracotomy (n = 3). Abdominal reoperation was performed in nine patients for abscess drainage (n = 9) and/or ring removal (n = 4) and/or nutritional access (n = 6). The source of the GBF was at the angle of His (n = 14). Furthermore, 14 patients presented a narrowing of the gastric pouch treated by 20 or 30 mm aggressive balloon dilation (n = 11), stricturotomy or septoplasty (n = 10) and/or stent (n = 7). Fibrin glue was used in one patient. We performed, on average, 4.5 endoscopic sessions per patient. Endotherapy led to a 93.3% (14 out of 15) success rate in GBF closure with an average healing time of 4.4 months (range, 1-10 months), being shorter in the stent group (2.5 × 9.5 months). There was no recurrence during the average 27.3-month follow-up. A patient persisted with GBF, despite the fibrin glue application, and decided to discontinue it. GBF is a highly morbid complication, which usually arises late in the postoperative period. Endotherapy through different strategies is a highly effective therapeutic option and should be implemented early in order to shorten leakage healing time. |
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Authors:
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Josemberg Marins Campos; Eduardo Franca Pereira; Luis Fernando Evangelista; Luciana Siqueira; Manoel Galvão Neto; Victor Dib; Marcelo Falcão; Vitor Arantes; Diego Awruch; Walton Albuquerque; João Ettinger; Almino Ramos; Alvaro Ferraz |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-6-4 |
Journal Detail:
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Title: Obesity surgery Volume: - ISSN: 1708-0428 ISO Abbreviation: - Publication Date: 2011 Jun |
Date Detail:
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Created Date: 2011-6-6 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9106714 Medline TA: Obes Surg Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Universidade Federal de Pernambuco, Rua Vigário Barreto, 127/802-Graças, 52020-140, Recife, PE, Brazil, josembergcampos@gmail.com. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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