Abstract：
BACKGROUND:As laparoscopic sleeve gastrectomy (LSG) is becoming the most popular bariatric procedure worldwide, treatment options for managing complications, in particular gastric leaks, are also emerging. Staple line leak is a major short-term complication of the procedure. Patients with persistent gastric leaks after failure of endoscopic and radiologic management are candidates for salvage surgery. Laparoscopic Roux-en-Y fistulo-jejunostomy (RYFJ) represents a surgical option to treat persistent gastric leak post-LSG. METHODS:We present the case of a 55-year-old woman undergoing laparoscopic double RYFJ for persistent gastric leaks after complicated bariatric surgery. The patient developed two chronic gastric leaks (gastro-esophageal and cardial localizations) following conversion to sleeve gastrectomy for failed vertical banded gastroplasty. With the two leaks being refractory to endoscopic treatment 6 months later after laparoscopic sleeve gastrectomy, salvage surgery was proposed. Surgery was performed laparoscopically, the gastric leak orifices were identified after careful dissection, and a double RYFJ was successfully completed. RESULTS:Postoperative course was uneventful. The patient remains in good health 6 months after surgery. CONCLUSIONS:Double LRYFJ for chronic leaks after complicated bariatric procedures seems safe with good postoperative outcomes. However, it remains a challenging procedure and should be reserved for selected patients in specialized bariatric centers.
journal_name
Obes Surgjournal_title
Obesity surgeryauthors
Amor IB,Lainas P,Kassir R,Etienne JH,Casanova V,Dagher I,Gugenheim Jdoi
10.1007/s11695-019-04255-ysubject
Has Abstractpub_date
2020-01-01 00:00:00pages
378-380issue
1eissn
0960-8923issn
1708-0428pii
10.1007/s11695-019-04255-yjournal_volume
30pub_type
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