Management of anastomotic leaks after Roux-en-Y bypass using self-expanding polyester stents.
BACKGROUND
To analyze the outcomes of a series of endoscopically placed polyester self-expanding polyflex stents (SEPSs) for the management of anastomotic leaks after Roux-en-Y bypass. Anastomotic leaks after gastric bypass cause significant morbidity and mortality. Covered polyester SEPSs might have a role in the treatment of these leaks.


METHODS
A retrospective chart review was performed from January 2006 to November 2006 that included all acute and chronic leaks treated with SEPSs.


RESULTS
A total of 6 patients were treated with stents, with a mean procedure time of 22 minutes. Of these 6 patients, 5 had acute postoperative leaks and 1 had a chronic fistula. Five patients started oral intake 1-6 days after their procedure. All acute leaks had complete healing at a median of 44 days. The patient with a chronic gastrocutaneous fistula required revisional surgery for fistula closure. In addition, 5 patients had stent migration, and 3 required stent replacement.


CONCLUSIONS
An endoscopically placed SEPS provides a less-invasive alternative to treat acute anastomotic leaks after Roux-en-Y bypass while simultaneously allowing oral intake. The results of this case series have demonstrated this treatment to be safe and effective.
Edwards
Christopher A
CA
Department of Surgery, University of Missouri-Columbia, Columbia, Missouri 65212, USA.
Bui
T Phiet
TP
Astudillo
J Andrés
JA
de la Torre
Roger A
RA
Miedema
Brent W
BW
Ramaswamy
Archana
A
Fearing
Nicole M
NM
Ramshaw
Bruce J
BJ
Thaler
Klaus
K
Scott
J Stephen
JS
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects*; D016099:Endoscopy, Gastrointestinal / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008875:Middle Aged; D009765:Obesity / Q000601:surgery; D011091:Polyesters; D011183:Postoperative Complications; D012086:Reoperation / Q000295:instrumentation; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
D011091:Polyesters