Endoscopic treatment of the fistulas after laparoscopic sleeve gastrectomy and Roux-en-Y gastric bypass.
OBJECTIVE
to evaluate the use of endoscopic self-expandable metallic prostheses in the treatment of fistulas from sleeve gastrectomy and Roux en y gastric bypass.


METHODS
all patients were treated with fully coated auto-expandable metallic prostheses and were submitted to laparoscopic or CT-guided drainage, except for those with intracavitary drains. After 6-8 weeks the prosthesis was removed and if the fistula was still open a new prostheses were positioned and kept for the same period.


RESULTS
the endoscopic treatment was successful in 25 (86.21%) patients. The main complication was the migration of the prosthesis in seven patients. Other complications included prosthesis intolerance, gastrointestinal bleeding and adhesions. The treatment failed in four patients (13.7%) one of which died (3.4%).


CONCLUSIONS
endoscopic treatment with fully coated self-expandable prosthesis was effective in treating most patients with fistula after sleeve gastrectomy and roux en y gastric bypass.
Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, RJ, BR.
Luís Gustavo Santos
LG
Périssé
Pontifícia Universidade Católica do Rio de Janeiro, RJ, BR.
Paulo Cezar Marques
PC
Périssé
Hospital Universitário Gaffrée e Guinle, Universidade Federal do Estado do Rio de Janeiro, RJ, BR.
Celso
C
Bernardo Júnior
D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D015390:Gastric Bypass; D005747:Gastric Fistula / Q000601:surgery*; D005773:Gastroscopy; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000601:surgery*; D019736:Prostheses and Implants; D055815:Young Adult