ENDOSCOPIC MANAGEMENT OF THE POST-OPERATIVE LEAKS AFTER A BARIATRIC SURGERY

2018 ◽  
Author(s):  
G Claudé ◽  
B Vedrenne ◽  
T Degand ◽  
P Claudé ◽  
JB Chevaux ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Endoscopic Management

Endoscopic Management of Postbariatric Fistulae and Leaks

2015 ◽  
Author(s):  
Yana Cavanagh ◽  
Sohail N. Shaikh
Keyword(s):  
Bariatric Surgery ◽  
Diagnostic Algorithm ◽  
Therapeutic Endoscopy ◽  
Late Complications ◽  
Endoscopic Management ◽  
High Morbidity ◽  
Management Options ◽  
Radiographic Findings ◽  
Computed Tomographic ◽  
American Society

The number of bariatric procedures performed annually is increasing along with the number of complications. Gastrointestinal leak after bariatric surgery generally portends high morbidity and mortality, and its management depends on clinical and radiographic presentation. A leak is defined as an enteric defect with extravasation of luminal contents. Fistulae are abnormal connections between two epithelialized surfaces, are usually chronic, and may develop from long-standing leaks. Endoscopic therapies may offer an attenuated risk profile compared with surgical intervention and play a growing role in the management of postbariatric complications. Leak resolution may require multiple endoscopic sessions and modalities (e.g., stents, adhesives, plugs, clips, suturing, and VAC-assisted closure); therefore, it is critical to have appropriate follow-up and surveillance after therapeutic endoscopic intervention. This review discusses endoscopic leak and fistula management through endoscopic procedures, addressing indications and candidates for procedure, contraindications, recipient evaluation, and aspects of procedure, including proper timing, equipment, and types. Figures show Roux-en-Y gastric bypass, sleeve gastrectomy, management options for leaks after bariatric surgery, a diagnostic algorithm for leaks, upper gastrointestinal series performed with Gastrografin, and computed tomographic scans that demonstrate extraluminal air extending along the diaphragmatic surface of the spleen and a perisplenic gas and fluid-filled collection on the lateral margin. Tables list complications that follow bariatric surgery; an excerpt from the 2008 American Society for Gastrointestinal Endoscopy Guidelines; recommended equipment for endoscopic defect management; classification system based on duration after bariatric surgery; classification and approach to management based on clinical presentation and radiographic findings; summary of recommendations for pre-endoscopy, index endoscopy, therapeutic endoscopy, and posttherapeutic endoscopy; and early and late complications of stent placement. This review contains 7 highly rendered figures, 7 tables, and 104 references.

scholarly journals Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis

2020 ◽  
Author(s):  
Pawel Rogalski ◽  
Agnieszka Swidnicka-Siergiejko ◽  
Justyna Wasielica-Berger ◽  
Damian Zienkiewicz ◽  
Barbara Wieckowska ◽  
...  
Keyword(s):  
Systematic Review ◽  
Bariatric Surgery ◽  
Meta Analysis ◽  
Endoscopic Management

Endoscopic Management of Post-bariatric Surgery Fistula: a Tertiary Care Center Experience

2018 ◽  
Vol 28 (12) ◽  
pp. 3910-3915 ◽  
Author(s):  
Hedi Benosman ◽  
Gabriel Rahmi ◽  
Guillaume Perrod ◽  
Mathieu Bruzzi ◽  
Elia Samaha ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Care Center ◽  
Tertiary Care ◽  
Endoscopic Management ◽  
Tertiary Care Center ◽  
Post Bariatric Surgery

scholarly journals Endoscopic management of post-bariatric surgery complications

2016 ◽  
Vol 8 (17) ◽  
pp. 591 ◽  
Author(s):  
Mena Boules ◽  
Julietta Chang ◽  
Ivy N Haskins ◽  
Gautam Sharma ◽  
Dvir Froylich ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Endoscopic Management ◽  
Surgery Complications ◽  
Bariatric Surgery Complications ◽  
Post Bariatric Surgery

Endoscopic management of complications of bariatric surgery

2019 ◽  
Vol 30 (4) ◽  
pp. 501-509
Author(s):  
C Rodríguez Ramos ◽  
P Guillén Mariscal ◽  
A Abraldes Bechiarelli ◽  
MÁ Mayo Ossorio ◽  
E Aycart Valdés ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Endoscopic Management ◽  
Management Of Complications

Resumen La prevalencia de la obesidad ha sufrido un rápido incremento en los últimos años a nivel mundial. La cirugía bariátrica constituye el tratamiento de primera línea para la obesidad mórbida, por lo que el número de procedimientos que se realizan se mantiene en aumento cada año. A pesar de los avances en la técnica quirúrgica las complicaciones no son infrecuentes y pueden ser potencialmente mortales. Las estrategias de manejo óptimo no están aún completamente definidas y existe un creciente número de publicaciones sobre este tema en los últimos años. La endoscopia diagnóstica y terapéutica juegan un papel fundamental en el adecuado manejo de estas complicaciones pero es técnicamente muy demandante. Es esencial para el endoscopista poseer un conocimiento básico sobre la anatomía quirúrgica y conocer la fisiopatología de estas complicaciones específicas. Es altamente recomendable que el endoscopista tenga una amplia y profunda experiencia en distintas técnicas y herramientas endoscópicas como la colocación de stents plásticos y metálicos, aplicación de clips e inyección de pegamentos, dilatación con balones o técnicas de sutura. Además, la estrecha cooperación entre el cirujano bariátrico y el endoscopista es el pilar para una adecuada estrategia de manejo de estas complicaciones ya que se necesita una aproximación conjunta y un tratamiento individualizados en la mayoría de los casos. En este artículo revisamos el estado actual y recientes innovaciones en el manejo endoscópico de las complicaciones más frecuentes tras la cirugía bariátrica, con especial atención al drenaje endoscópico interno como cambio de paradigma en el tratamiento de fugas y fístulas, el manejo de fugas agudas en pacientes estables mediante stents metálicos autoexpandibles cubiertos y el tratamiento d las estenosis de la manga gástrica con balones de dilatación de acalasia.

Mo2020 Advanced Endoscopic Management of Severe, Complex Bariatric Surgery Complications

2016 ◽  
Vol 83 (5) ◽  
pp. AB497
Author(s):  
Paul T. Kroner ◽  
Ivan Jovanovic ◽  
Kondal R. Kyanam Kabir Baig ◽  
Juan P. Gutierrez ◽  
Marco A. D'Assuncao ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Endoscopic Management ◽  
Surgery Complications ◽  
Bariatric Surgery Complications

scholarly journals A comparison of endoscopic and non-endoscopic biliary intervention outcomes in patients with prior bariatric surgery

2018 ◽  
Vol 06 (01) ◽  
pp. E11-E28
Author(s):  
Amrit Kamboj ◽  
Victorio Pidlaoan ◽  
Mohammad Shakhatreh ◽  
Alice Hinton ◽  
Darwin Conwell ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Nationwide Inpatient Sample ◽  
Cost Effective ◽  
Hospital Charges ◽  
Endoscopic Management ◽  
Inpatient Mortality ◽  
Total Hospital ◽  
Cost Effective Approach ◽  
History Of ◽  
The Mean

Abstract Background and study aims Endoscopic biliary intervention (BI) is often difficult to perform in patients with prior bariatric surgery (BRS). We sought to analyze outcomes of patients with prior BRS undergoing endoscopic and non-endoscopic BI. Patients and methods The Nationwide Inpatient Sample (2007 – 2011) was reviewed to identify all adult inpatients (≥ 18 years) with a history of BRS undergoing BI. The clinical outcomes of interest were in-patient mortality, length of stay (LOS), and total hospital charges. Results There were 7,343 patients with prior BRS who underwent BIs where a majority were endoscopic (4,482 vs. 2,861, P < 0.01). The mean age was 50±30.8 years and the majority were females (80.5 %). Gallstone-related disease was the most common indication for BI and managed more often with primary endoscopic management (2,146 vs. 1,132, P < 0.01). Inpatient mortality was not significantly different between patients undergoing primary endoscopic versus non-endoscopic BI (0.2 % vs. 0.7 %, P = 0.2). Patients with sepsis were significantly more likely to incur failed primary endoscopic BI (OR 2.74, 95 % CI 1.15, 6.53) and were more likely to be managed with non-endoscopic BI (OR 2.13, 95 % CI 1.3, 3.5). Primary non-endoscopic BI and failed endoscopic BI were both associated with longer LOS (by 1.77 days, P < 0.01 and by 2.17 days, P < 0.01, respectively) and higher hospitals charges (by $11,400, P < 0.01 and by $ 14,200, P < 0.01, respectively). Conclusion Primary endoscopic management may be a safe and cost-effective approach for patients with prior BRS who need BI. While primary endoscopic biliary intervention is more common, primary non-endoscopic intervention may be used more often for sepsis.

scholarly journals Advances in the Endoscopic Management of Obesity

2015 ◽  
Vol 2015 ◽  
pp. 1-9 ◽  
Author(s):  
Jason Behary ◽  
Vivek Kumbhari
Keyword(s):  
Bariatric Surgery ◽  
Minimally Invasive ◽  
Mortality Rates ◽  
Endoscopic Management ◽  
Obese Patients ◽  
Minimally Invasive Techniques ◽  
Substantial Cost ◽  
The Past ◽  
Invasive Techniques

Obesity has become a worldwide epidemic with significant impact on quality of life, morbidity, and mortality rates. Over the past two decades, bariatric surgery has established itself as the most effective and durable treatment for patients with obesity and its associated comorbidities. However, despite the use of minimally invasive techniques, bariatric surgery is associated with complications in approximately 15% of patients, has a substantial cost, and is used by only 1% of patients who are eligible. Therefore, there is a need for effective minimally invasive therapies, which will be utilized by the large proportion of obese patients who are in desperate need of treatment but are not receiving any. Endoscopic approaches to the management of obesity have been developed, with the aim of delivering more effective, durable, and safer methods of weight reduction. In this paper, we review currently available and future endoscopic therapies that will likely join the armamentarium used in the management of obesity.

Endoscopic management of refractory leaks and fistulas after bariatric surgery with long-term follow-up

2020 ◽  
Author(s):  
Veeravich Jaruvongvanich ◽  
Reem Matar ◽  
Andrew C. Storm ◽  
Azizullah Beran ◽  
Konstantinos Malandris ◽  
...  
Keyword(s):  
Bariatric Surgery ◽  
Endoscopic Management ◽  
Long Term Follow Up
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