Percutaneous embolization for a subacute gastric fistula following laparoscopic sleeve gastrectomy: a case report and literature review

BMC Surgery

Kao-Lang Liu¹  Hung-Hsuan Yen²  Jin-Ming Wu²  Yu-Ting Lin³  Ming-Tsan Lin³ 

[1] Department of Medical Imaging, National Taiwan University Cancer Center, National Taiwan University Hospital, National Taiwan University College of Medicine;Department of Surgery, National Taiwan University Hospital Hsin-Chu Biomedical Park Branch;Department of Surgery, National Taiwan University Hospital;

关键词: Fistula;    Leak;    Sleeve gastrectomy;    Bariatric surgery;    Embolization;   

DOI  :  10.1186/s12893-020-00896-4

来源: DOAJ

【 摘 要 】

Abstract Background The management for subacute or chronic fistula after bariatric surgery is very complicated and with no standard protocol yet. It is also an Achilles’ heel of all bariatric surgery. The aim of this case report is to describe our experience in managing this complication by percutaneous embolization, a less commonly used method. Case presentation A 23-year-old woman with a body mass index of 35.7 kg/m2 presented with delayed gastric leak 7 days after laparoscopic sleeve gastrectomy (LSG) for weight reduction. Persistent leak was still noted under the status of nil per os, nasogastric decompression, and parenteral nutrition for 1 month; therefore, endoscopic glue injection was performed. The fistula tract did not seal off, and the size of pseudocavity enlarged after gas inflation during endoscopic intervention. Subsequently, we successfully managed this subacute gastric fistula via percutaneous fistula tract embolization (PFTE) with removal of the external drain 2 months after LSG. Conclusions PFTE can serve as one of the non-invasive methods to treat subacute gastric fistula after LSG. The usage of fluoroscopy-visible glue for embolization can seal the fistula tract precisely and avoid the negative impact from gas inflation during endoscopic intervention.

【 授权许可】

Unknown