title: Percutaneous transesophageal gastro-tubing for management of gastric leakage after sleeve gastrectomy.
abstract: Gastric leakage is a challenging complication of sleeve gastrectomy. Multimodal approaches, including drainage, clipping, and stenting of the leak, are occasionally insufficient. We report successful management of refractory gastric leakage using percutaneous transesophageal gastro-tubing (PTEG). Drainage and stenting proved inadequate for treating sleeve leakage near the esophagogastric junction in two patients. PTEG was finally performed, and enteral feeding was started on the following day. The patients were discharged within 1 week. The PTEG-tube was removed after confirming oral food intake. Both patients continue to do well without recurrence. PTEG was developed for patients who are unsuitable for percutaneous endoscopic gastrostomy. PTEG provides decompression and permits enteral feeding in patients refractory to other endoscopic treatments. PTEG is an option for managing intractable sleeve leakage without surgery.
authors.affiliation: Department of Surgery, Toho University Medical Center, Sakura Hospital, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan, oshiro@sakura.med.toho-u.ac.jp.
authors.forename: Takashi
authors.initials: T
authors.lastname: Oshiro
authors.forename: Atsuhito
authors.initials: A
authors.lastname: Saiki
authors.forename: Junichi
authors.initials: J
authors.lastname: Suzuki
authors.forename: Ayami
authors.initials: A
authors.lastname: Satoh
authors.forename: Tomoaki
authors.initials: T
authors.lastname: Kitahara
authors.forename: Kengo
authors.initials: K
authors.lastname: Kadoya
authors.forename: Ayako
authors.initials: A
authors.lastname: Moriyama
authors.forename: Mitsuru
authors.initials: M
authors.lastname: Ooshiro
authors.forename: Makoto
authors.initials: M
authors.lastname: Nagashima
authors.forename: Youngjin
authors.initials: Y
authors.lastname: Park
authors.forename: Shinichi
authors.initials: S
authors.lastname: Okazumi
authors.forename: Ryoji
authors.initials: R
authors.lastname: Katoh
mesh_terms: D000328:Adult; D004322:Drainage; D004943:Esophagogastric Junction / Q000601:surgery*; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*