Laparoscopic total gastrectomy with roux-y esophagojejunostomy for chronic gastric fistula after laparoscopic sleeve gastrectomy

Almog Ben Yaacov, Eran Sadot, Matan Ben David, Nir Wasserberg, Andrei Keidar

Research output: Contribution to journalArticlepeer-review

20 Scopus citations

Abstract

Laparoscopic sleeve gastrectomy is a restrictive operation with hormonal elements that is rapidly gaining popularity. The most feared complication of the procedure is a staple line leak. The treatment of staple line leakage depends on timing and clinical and anatomical considerations. If leakage persists and transforms into a chronic fistula, a definitive surgical procedure is required. In cases where the fistula originates close to the esophagogastric junction, the surgical possibilities are limited and one treatment option is total gastrectomy with esophagojejunal anastomosis. We report a case series of four patientswith chronic fistulae, who failed conservative treatment and required total gastrectomy. Their average length of hospital stay was 8.7 days (range, 5-15 days), without conversions, leaks, or other complications. In experienced hands, total gastrectomy is feasible by laparoscopic techniques and should be performed soon after the fistula is established.

Original languageEnglish
Pages (from-to)425-429
Number of pages5
JournalObesity Surgery
Volume24
Issue number3
DOIs
StatePublished - 1 Jan 2014
Externally publishedYes

Keywords

  • Esophagojejunal anastomosis
  • Fistula
  • Laparoscopic sleeve gastrectomy complications
  • Laparoscopic total gastrectomy
  • Leak

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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