ArticleObesity surgery2016
Laparoscopic Roux En Y Esophago-Jejunostomy for Chronic Leak/Fistula After Laparoscopic Sleeve Gastrectomy.
Article in Obesity surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it, 23 citations in OpenAlex.
- Efficacy and Safety of the Over-the-Scope Clip (OTSC) System in the Management of Leak and Fistula After Laparoscopic Sleeve Gastrectomy: a Systematic Review.Obesity surgery · 2017Pooled it
- Comparison of long-term quality of life outcomes between endoscopic vacuum therapy and other treatments for upper gastrointestinal leaks.Surgical endoscopy · 2023Article
- Roux-en-Y Gastric Bypass for the Treatment of Leak Following Sleeve Gastrectomy.Obesity surgery · 2021Article
- Revisional Surgeries of Laparoscopic Sleeve Gastrectomy.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Review
- Laparoscopic Roux-en-Y Double Fistulo-Jejunostomy for Chronic Gastric Leaks After Converted Vertical Banded Gastroplasty to Sleeve Gastrectomy.Obesity surgery · 2020Article
- Mini gastric bypass for the management of gastrobronchial fistula: A case report.International journal of surgery case reports · 2020Article
- Laparoscopic Roux-En-Y Fistulo-Jejunostomy, a Preferred Technique after Failure of Endoscopic and Radiologic Management of Fistula Post Sleeve Gastrectomy.Obesity surgery · 2019Article
- An Odyssey of complications from band, to sleeve, to bypass; definitive laparoscopic completion gastrectomy with distal esophagectomy and esophagojejunostomy for persistent leak.Surgical endoscopy · 2018Article
- Response to Letter to the Editor: Successful Management of Laparoscopic Sleeve Gastrectomy Leak with Negative Pressure Therapy.Obesity surgery · 2017Article
- Staple line leak with peritonitis after laparoscopic sleeve gastrectomy - a solution in one to six steps.Wideochirurgia i inne techniki maloinwazyjne = Videosurgery and other miniinvasive techniques · 2017Article
- Medical Malpractice in Bariatric Surgery: a Review of 140 Medicolegal Claims.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2017Article
- Management of Staple Line Leaks after Laparoscopic Sleeve Gastrectomy.JSLS : Journal of the Society of Laparoendoscopic SurgeonsArticle
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLeak following laparoscopic sleeve gastrectomy (LSG) is one of the most serious and devastating complications. Endoscopic stents can treat most early LSG leaks, but is not as effective for chronic LSG leaks/fistulae. The surgical options to treat a chronic leak/fistula after LSG are laparoscopic Roux en Y esophago-jejunostomy (LRYEJ) or laparoscopic Roux en Y fistulo-jejunostomy.
methodsWe reviewed our prospective database for all patients with leak after LSG treated with LRYEJ. We have described our algorithm for managing LSG previously. We prefer to optimize the nutritional status of patients with enteral rather than parenteral nutrition and drain all collections prior to LRYEJ.
resultsWe have treated four patients utilizing our technique of LRYEJ. Initial endoscopic stent placement was attempted in all four patients (two failed to resolve (50 %) and two had distal stenosis at the incisura not amenable to endoscopic stenting). We utilized enteral feeding through either naso-jejunal (NJ) or jejunostomy tube feeding in 3/4 (75 %) of patients, and in one patient with stenosis, we could not introduce a NJ tube endoscopically due to tight stricture. This patient was placed on total parenteral nutrition (TPN) and went on to develop pulmonary embolism. None of the patient developed leak after LRYEJ. The only patient with stenosis (25 %) had antecolic LRYEJ. In contrast, all patients who had retrocolic LRYGB laparoscopically did not develop stenosis.
conclusionsLaparoscopic Roux en Y esophago-jejunostomy for chronic leak/fistula after is safe and effective. Preoperative enteral nutrition is important.
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