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Obesity Surgery

, Volume 29, Issue 1, pp 356–357 | Cite as

Total Gastrectomy with Roux-En-Y esophagojejunostomy for Chronic Complicated Post-Sleeve Gastric Fistula—Video Report

  • Georges Bou NassifEmail author
  • Luca Paolino
  • Andrea Lazzati
Video Submission
  • 78 Downloads

Abstract

Introduction

Laparoscopic sleeve gastrectomy (LSG) has become one of the most popular bariatric surgeries worldwide. However, complications related to the stapler line can be very serious. Among several challenging post-LSG complications, fistula is the most feared. Its management can be very challenging and chronic. In case of chronic fistula and failure of surgical, endoscopic, and radiological treatment, total gastrectomy with esojejunal anastomosis (RYOJ) can be considered as an effective solution. We describe in this video the steps of our laparoscopic technique.

Methods

We have performed a total gastrectomy with RYOJ in a particular patient with chronic and persisting gastric fistula 9 months after LSG. The body mass index (BMI) was initially 50 kg/m2 at the time of the LSG against 31 kg/m2 on the day of the RYOJ.

Results

The postoperative course was uneventful. An upper GI series was done at 1 week and 1 month postoperatively without any abnormality. The patient was evaluated clinically and biologically at 1, 3, and 6 months later on with no evidence of dysphasia or biological abnormality.

Conclusion

RYOJ in our particular case was efficient. However, longer series and longer follow-up are needed to confirm the effectiveness of this rescue procedure.

Keywords

Sleeve gastrectomy Chronic fistula Roux-en-Y esophagojejunostomy 

Notes

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflicts of interest.

Informed Consent

Informed consent was obtained from the individual participant included in the study.

Ethical Approval

The procedure was performed in accordance with the ethical standards of the institutional and the national research committee.

Disclosures

Dr. Georges Bou Nassif did not receive any payment or services from a third party (government, commercial, private foundation, etc.) for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.).

Dr. Andrea Lazzati did not receive any payment or services from a third party (government, commercial, private foundation, etc.) for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.).

Dr. Luca Paolino did not receive any payment or services from a third party (government, commercial, private foundation, etc.) for any aspect of the submitted work (including but not limited to grants, data monitoring board, study design, manuscript preparation, statistical analysis, etc.).

Dr. Georges Bou Nassif, corresponding author of this study, certify that the manuscript did not involve the use of animal or human subjects.

Supplementary material

11695_2018_3551_MOESM1_ESM.mp4 (139.8 mb)
ESM 1 (MP4 143,121 kb)

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of General SurgeryCenter Hospitalier Intercommunal de CréteilCréteilFrance
  2. 2.INSERM, UMR_S 1138, Centre de Recherche des CordeliersUniversité Paris DescartesParisFrance

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