Management of Type 1 Late Sleeve Leak with Gastrobronchial Fistula by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report
Background Gastrobronchial fistula (GBF) is a rare but serious complication after laparoscopic sleeve gastrectomy (LSG). It commonly appears sometime after the primary LSG. (Alharbi Ann Thorac Med. 8(3):179–80, 2013 ; Albanopoulos et al. Surg Obes Relat Dis. 9(6):e97–9, 2013 ). Surgical approach is...
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| creator | Praveenraj, Palanivelu Gomes, Rachel M. Kumar, Saravana Senthilnathan, Palanisamy Parthasarathi, Ramakrishnan Rajapandian, Subbiah Palanivelu, Chinnusamy |
| description | Background
Gastrobronchial fistula (GBF) is a rare but serious complication after laparoscopic sleeve gastrectomy (LSG). It commonly appears sometime after the primary LSG. (Alharbi Ann Thorac Med. 8(3):179–80,
2013
; Albanopoulos et al. Surg Obes Relat Dis. 9(6):e97–9,
2013
). Surgical approach is an effective treatment. (Rebibo et al. Surg Obes Relat Dis. 10(3):460–67,
2014
).
The aim of this video was to demonstrate the operative management of a gastrobronchial fistula after LSG by laparoscopic suturing and conversion to a Roux-en-Y gastric bypass (RYGB).
Methods
We present the case of a 53-year-old woman, with a BMI of 50.2 who presented with a left lower lobe consolidation 7 months after LSG. Imaging revealed a gastrobronchial fistula with left lower lobe consolidation and small sub-diaphragmatic collections. Endoscopy done revealed a fistulous opening beyond the oesophago-gastric junction and a trial of endoscopic stenting failed.
Results
In this multimedia high definition video, we present step-by-step the operative management of a late sleeve leak with gastrobronchial fistula by laparoscopic suturing and conversion to a RYGB. The procedure included mobilization of the gastric sleeve, identification and suturing of the fistulous opening, creation of a gastric pouch, creation of an ante-colic Roux limb, gastro-jejunal anastomosis and jejuno-jejunal anastomosis. Drainage of the fistula decreased with absence of a leak on imaging and pneumonia resolved in 15 days. This patient was diagnosed 7 months postoperatively with a gastric sleeve leak and the time to fistula closure from diagnosis was 2 months.
Conclusion
GBF is a severe complication of bariatric surgery that usually presents late in the postoperative period. GBF after LSG can be treated by surgical fistula repair and conversion of the sleeve into a RYGB. |
| doi_str_mv | 10.1007/s11695-015-1912-3 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1764698578</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>3865603581</sourcerecordid><originalsourceid>FETCH-LOGICAL-c485t-2f4433d9bd5341dd13a8a0afa0421085426de487dad4fdc4ed85039b53ca17d13</originalsourceid><addsrcrecordid>eNp1kUtv1DAUhS0EokPhB7BBlth0Y_AricMORn0gDUKiD4lVdBPftCkZO9hO6fwPfjAepSCExOou_J1zr88h5KXgbwTn1dsoRFkXjIuCiVpIph6Rlai4YVxL85iseF1yZmqpDsizGG85l6KU8ik5kKUutdTFivz8BA6ucYsuUd_Ti92EVNANJKTnI-Id0g3CN_pjSDf0FGIKvg3edTcDjPRkiGkegba7LJgg-Nj5aejo-ZzmMLhrCs7StXd3GOLgHU2efvHzPUPHvi5mGf6wmyDGd_RqsJjfcfIhPSdPehgjvniYh-Ty5PhifcY2n08_rt9vWKdNkZjstVbK1q0tlBbWCgUGOPSQvy-4KbQsLWpTWbC6t51Gawqu6rZQHYgq44fkaPGdgv8-Y0zNdogdjiM49HNsRJVzqk1RmYy-_ge99XNw-bpMKVnnA8o6U2KhuhxGDNg3Uxi2EHaN4M2-smaprMmVNfvKGpU1rx6c53aL9o_id0cZkAsQp32qGP5a_V_XX5-VocQ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1732934169</pqid></control><display><type>article</type><title>Management of Type 1 Late Sleeve Leak with Gastrobronchial Fistula by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report</title><source>MEDLINE</source><source>SpringerNature Journals</source><creator>Praveenraj, Palanivelu ; Gomes, Rachel M. ; Kumar, Saravana ; Senthilnathan, Palanisamy ; Parthasarathi, Ramakrishnan ; Rajapandian, Subbiah ; Palanivelu, Chinnusamy</creator><creatorcontrib>Praveenraj, Palanivelu ; Gomes, Rachel M. ; Kumar, Saravana ; Senthilnathan, Palanisamy ; Parthasarathi, Ramakrishnan ; Rajapandian, Subbiah ; Palanivelu, Chinnusamy</creatorcontrib><description>Background
Gastrobronchial fistula (GBF) is a rare but serious complication after laparoscopic sleeve gastrectomy (LSG). It commonly appears sometime after the primary LSG. (Alharbi Ann Thorac Med. 8(3):179–80,
2013
; Albanopoulos et al. Surg Obes Relat Dis. 9(6):e97–9,
2013
). Surgical approach is an effective treatment. (Rebibo et al. Surg Obes Relat Dis. 10(3):460–67,
2014
).
The aim of this video was to demonstrate the operative management of a gastrobronchial fistula after LSG by laparoscopic suturing and conversion to a Roux-en-Y gastric bypass (RYGB).
Methods
We present the case of a 53-year-old woman, with a BMI of 50.2 who presented with a left lower lobe consolidation 7 months after LSG. Imaging revealed a gastrobronchial fistula with left lower lobe consolidation and small sub-diaphragmatic collections. Endoscopy done revealed a fistulous opening beyond the oesophago-gastric junction and a trial of endoscopic stenting failed.
Results
In this multimedia high definition video, we present step-by-step the operative management of a late sleeve leak with gastrobronchial fistula by laparoscopic suturing and conversion to a RYGB. The procedure included mobilization of the gastric sleeve, identification and suturing of the fistulous opening, creation of a gastric pouch, creation of an ante-colic Roux limb, gastro-jejunal anastomosis and jejuno-jejunal anastomosis. Drainage of the fistula decreased with absence of a leak on imaging and pneumonia resolved in 15 days. This patient was diagnosed 7 months postoperatively with a gastric sleeve leak and the time to fistula closure from diagnosis was 2 months.
Conclusion
GBF is a severe complication of bariatric surgery that usually presents late in the postoperative period. GBF after LSG can be treated by surgical fistula repair and conversion of the sleeve into a RYGB.</description><identifier>ISSN: 0960-8923</identifier><identifier>EISSN: 1708-0428</identifier><identifier>DOI: 10.1007/s11695-015-1912-3</identifier><identifier>PMID: 26464245</identifier><language>eng</language><publisher>New York: Springer US</publisher><subject>Anastomotic Leak - surgery ; Bronchial Fistula - etiology ; Bronchial Fistula - surgery ; Female ; Gastrectomy - adverse effects ; Gastric Bypass ; Gastric Fistula - etiology ; Gastric Fistula - surgery ; Gastrointestinal surgery ; Humans ; Laparoscopy ; Medicine ; Medicine & Public Health ; Middle Aged ; Obesity ; Obesity, Morbid - surgery ; Surgery ; Surgical outcomes ; Video Submission</subject><ispartof>Obesity surgery, 2015-12, Vol.25 (12), p.2462-2462</ispartof><rights>Springer Science+Business Media New York 2015</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c485t-2f4433d9bd5341dd13a8a0afa0421085426de487dad4fdc4ed85039b53ca17d13</citedby><cites>FETCH-LOGICAL-c485t-2f4433d9bd5341dd13a8a0afa0421085426de487dad4fdc4ed85039b53ca17d13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s11695-015-1912-3$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s11695-015-1912-3$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,780,784,27924,27925,41488,42557,51319</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26464245$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Praveenraj, Palanivelu</creatorcontrib><creatorcontrib>Gomes, Rachel M.</creatorcontrib><creatorcontrib>Kumar, Saravana</creatorcontrib><creatorcontrib>Senthilnathan, Palanisamy</creatorcontrib><creatorcontrib>Parthasarathi, Ramakrishnan</creatorcontrib><creatorcontrib>Rajapandian, Subbiah</creatorcontrib><creatorcontrib>Palanivelu, Chinnusamy</creatorcontrib><title>Management of Type 1 Late Sleeve Leak with Gastrobronchial Fistula by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report</title><title>Obesity surgery</title><addtitle>OBES SURG</addtitle><addtitle>Obes Surg</addtitle><description>Background
Gastrobronchial fistula (GBF) is a rare but serious complication after laparoscopic sleeve gastrectomy (LSG). It commonly appears sometime after the primary LSG. (Alharbi Ann Thorac Med. 8(3):179–80,
2013
; Albanopoulos et al. Surg Obes Relat Dis. 9(6):e97–9,
2013
). Surgical approach is an effective treatment. (Rebibo et al. Surg Obes Relat Dis. 10(3):460–67,
2014
).
The aim of this video was to demonstrate the operative management of a gastrobronchial fistula after LSG by laparoscopic suturing and conversion to a Roux-en-Y gastric bypass (RYGB).
Methods
We present the case of a 53-year-old woman, with a BMI of 50.2 who presented with a left lower lobe consolidation 7 months after LSG. Imaging revealed a gastrobronchial fistula with left lower lobe consolidation and small sub-diaphragmatic collections. Endoscopy done revealed a fistulous opening beyond the oesophago-gastric junction and a trial of endoscopic stenting failed.
Results
In this multimedia high definition video, we present step-by-step the operative management of a late sleeve leak with gastrobronchial fistula by laparoscopic suturing and conversion to a RYGB. The procedure included mobilization of the gastric sleeve, identification and suturing of the fistulous opening, creation of a gastric pouch, creation of an ante-colic Roux limb, gastro-jejunal anastomosis and jejuno-jejunal anastomosis. Drainage of the fistula decreased with absence of a leak on imaging and pneumonia resolved in 15 days. This patient was diagnosed 7 months postoperatively with a gastric sleeve leak and the time to fistula closure from diagnosis was 2 months.
Conclusion
GBF is a severe complication of bariatric surgery that usually presents late in the postoperative period. GBF after LSG can be treated by surgical fistula repair and conversion of the sleeve into a RYGB.</description><subject>Anastomotic Leak - surgery</subject><subject>Bronchial Fistula - etiology</subject><subject>Bronchial Fistula - surgery</subject><subject>Female</subject><subject>Gastrectomy - adverse effects</subject><subject>Gastric Bypass</subject><subject>Gastric Fistula - etiology</subject><subject>Gastric Fistula - surgery</subject><subject>Gastrointestinal surgery</subject><subject>Humans</subject><subject>Laparoscopy</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Obesity</subject><subject>Obesity, Morbid - surgery</subject><subject>Surgery</subject><subject>Surgical outcomes</subject><subject>Video Submission</subject><issn>0960-8923</issn><issn>1708-0428</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><recordid>eNp1kUtv1DAUhS0EokPhB7BBlth0Y_AricMORn0gDUKiD4lVdBPftCkZO9hO6fwPfjAepSCExOou_J1zr88h5KXgbwTn1dsoRFkXjIuCiVpIph6Rlai4YVxL85iseF1yZmqpDsizGG85l6KU8ik5kKUutdTFivz8BA6ucYsuUd_Ti92EVNANJKTnI-Id0g3CN_pjSDf0FGIKvg3edTcDjPRkiGkegba7LJgg-Nj5aejo-ZzmMLhrCs7StXd3GOLgHU2efvHzPUPHvi5mGf6wmyDGd_RqsJjfcfIhPSdPehgjvniYh-Ty5PhifcY2n08_rt9vWKdNkZjstVbK1q0tlBbWCgUGOPSQvy-4KbQsLWpTWbC6t51Gawqu6rZQHYgq44fkaPGdgv8-Y0zNdogdjiM49HNsRJVzqk1RmYy-_ge99XNw-bpMKVnnA8o6U2KhuhxGDNg3Uxi2EHaN4M2-smaprMmVNfvKGpU1rx6c53aL9o_id0cZkAsQp32qGP5a_V_XX5-VocQ</recordid><startdate>20151201</startdate><enddate>20151201</enddate><creator>Praveenraj, Palanivelu</creator><creator>Gomes, Rachel M.</creator><creator>Kumar, Saravana</creator><creator>Senthilnathan, Palanisamy</creator><creator>Parthasarathi, Ramakrishnan</creator><creator>Rajapandian, Subbiah</creator><creator>Palanivelu, Chinnusamy</creator><general>Springer US</general><general>Springer Nature B.V</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>K9.</scope><scope>M0S</scope><scope>M1P</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope></search><sort><creationdate>20151201</creationdate><title>Management of Type 1 Late Sleeve Leak with Gastrobronchial Fistula by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report</title><author>Praveenraj, Palanivelu ; Gomes, Rachel M. ; Kumar, Saravana ; Senthilnathan, Palanisamy ; Parthasarathi, Ramakrishnan ; Rajapandian, Subbiah ; Palanivelu, Chinnusamy</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c485t-2f4433d9bd5341dd13a8a0afa0421085426de487dad4fdc4ed85039b53ca17d13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Anastomotic Leak - surgery</topic><topic>Bronchial Fistula - etiology</topic><topic>Bronchial Fistula - surgery</topic><topic>Female</topic><topic>Gastrectomy - adverse effects</topic><topic>Gastric Bypass</topic><topic>Gastric Fistula - etiology</topic><topic>Gastric Fistula - surgery</topic><topic>Gastrointestinal surgery</topic><topic>Humans</topic><topic>Laparoscopy</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Obesity</topic><topic>Obesity, Morbid - surgery</topic><topic>Surgery</topic><topic>Surgical outcomes</topic><topic>Video Submission</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Praveenraj, Palanivelu</creatorcontrib><creatorcontrib>Gomes, Rachel M.</creatorcontrib><creatorcontrib>Kumar, Saravana</creatorcontrib><creatorcontrib>Senthilnathan, Palanisamy</creatorcontrib><creatorcontrib>Parthasarathi, Ramakrishnan</creatorcontrib><creatorcontrib>Rajapandian, Subbiah</creatorcontrib><creatorcontrib>Palanivelu, Chinnusamy</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Public Health Database</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><jtitle>Obesity surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Praveenraj, Palanivelu</au><au>Gomes, Rachel M.</au><au>Kumar, Saravana</au><au>Senthilnathan, Palanisamy</au><au>Parthasarathi, Ramakrishnan</au><au>Rajapandian, Subbiah</au><au>Palanivelu, Chinnusamy</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Management of Type 1 Late Sleeve Leak with Gastrobronchial Fistula by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report</atitle><jtitle>Obesity surgery</jtitle><stitle>OBES SURG</stitle><addtitle>Obes Surg</addtitle><date>2015-12-01</date><risdate>2015</risdate><volume>25</volume><issue>12</issue><spage>2462</spage><epage>2462</epage><pages>2462-2462</pages><issn>0960-8923</issn><eissn>1708-0428</eissn><abstract>Background
Gastrobronchial fistula (GBF) is a rare but serious complication after laparoscopic sleeve gastrectomy (LSG). It commonly appears sometime after the primary LSG. (Alharbi Ann Thorac Med. 8(3):179–80,
2013
; Albanopoulos et al. Surg Obes Relat Dis. 9(6):e97–9,
2013
). Surgical approach is an effective treatment. (Rebibo et al. Surg Obes Relat Dis. 10(3):460–67,
2014
).
The aim of this video was to demonstrate the operative management of a gastrobronchial fistula after LSG by laparoscopic suturing and conversion to a Roux-en-Y gastric bypass (RYGB).
Methods
We present the case of a 53-year-old woman, with a BMI of 50.2 who presented with a left lower lobe consolidation 7 months after LSG. Imaging revealed a gastrobronchial fistula with left lower lobe consolidation and small sub-diaphragmatic collections. Endoscopy done revealed a fistulous opening beyond the oesophago-gastric junction and a trial of endoscopic stenting failed.
Results
In this multimedia high definition video, we present step-by-step the operative management of a late sleeve leak with gastrobronchial fistula by laparoscopic suturing and conversion to a RYGB. The procedure included mobilization of the gastric sleeve, identification and suturing of the fistulous opening, creation of a gastric pouch, creation of an ante-colic Roux limb, gastro-jejunal anastomosis and jejuno-jejunal anastomosis. Drainage of the fistula decreased with absence of a leak on imaging and pneumonia resolved in 15 days. This patient was diagnosed 7 months postoperatively with a gastric sleeve leak and the time to fistula closure from diagnosis was 2 months.
Conclusion
GBF is a severe complication of bariatric surgery that usually presents late in the postoperative period. GBF after LSG can be treated by surgical fistula repair and conversion of the sleeve into a RYGB.</abstract><cop>New York</cop><pub>Springer US</pub><pmid>26464245</pmid><doi>10.1007/s11695-015-1912-3</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Anastomotic Leak - surgery Bronchial Fistula - etiology Bronchial Fistula - surgery Female Gastrectomy - adverse effects Gastric Bypass Gastric Fistula - etiology Gastric Fistula - surgery Gastrointestinal surgery Humans Laparoscopy Medicine Medicine & Public Health Middle Aged Obesity Obesity, Morbid - surgery Surgery Surgical outcomes Video Submission |
| title | Management of Type 1 Late Sleeve Leak with Gastrobronchial Fistula by Laparoscopic Suturing and Conversion to Roux-en-Y Gastric Bypass: Video Report |
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