Management of Gastrointestinal Leaks and Fistula
Bariatric operations involving gastrointestinal resection and/or reconstruction can be associated with gastrointestinal leaks and fistula. Common bariatric operations that can lead to development of gastrointestinal leaks include Roux-en-Y gastric bypass, sleeve gastrectomy, and the duodenal switch operation. Expeditious recognition and early institution of management for gastrointestinal leaks are keys to minimize the progression from systemic inflammatory response to eventual sepsis. Prompt management of gastrointestinal leak can also minimize the risk for development of a chronic fistula, which is often difficult to treat. This chapter reviews the etiologies of gastrointestinal leaks, common presenting signs and symptoms, diagnostic evaluation, and management of acute gastrointestinal leaks and chronic fistula.
KeywordsSepsis Gastrointestinal leak Ischemia Toxicity Washout Stent
- 2.Clinical Issues Committee of the American Society for Metabolic and Bariatric Surgery. Updated position statement on the prevention and detection of gastrointestinal leak. May 2015.Google Scholar
- 20.Freedman J, Jonas E, Näslund E, Nilsson H, Marsk R, Stockeld D. Treatment of leaking gastrojejunostomy after gastric bypass surgery with special emphasis on stenting. Surg Obes Relat Dis. 2013;9(4):554–8. in pressGoogle Scholar