Gastrogastric fistula: a possible complication of Roux-en-Y gastric bypass

Gastrogastric fistula is a communication between the proximal gastric pouch and the distal gastric remnant, rarely described in the realm of bariatric procedures. The aim of this study was to review the existing literature about this topic and to demonstrate its laparoscopic treatment. An extensive...

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Bibliographic Details
Published in:Journal of the Society of Laparoendoscopic Surgeons 2006-07, Vol.10 (3), p.326-331
Main Authors: Filho, Alcides José Branco, Kondo, William, Nassif, Luis Sérgio, Garcia, Mariana Jorge, Tirapelle, Rafael de Almeida, Dotti, Carlos Marcelo
Format: Article
Language:English
Subjects:
Anastomosis, Roux-en-Y
Gastric Bypass
Gastric Fistula - diagnosis
Gastric Fistula - etiology
Gastric Fistula - surgery
Humans
Laparoscopy - methods
Postoperative Complications
Scientific Papers
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Summary:Gastrogastric fistula is a communication between the proximal gastric pouch and the distal gastric remnant, rarely described in the realm of bariatric procedures. The aim of this study was to review the existing literature about this topic and to demonstrate its laparoscopic treatment. An extensive literature review found several articles reporting this complication. However, no citation was found describing the steps of the laparoscopic management of this situation. Gastrogastric fistula occurs in up to 6% of Roux-en-Y gastric bypasses. Two theories exist for fistula formation: (1) it is a technical complication derived from the incomplete division of the stomach during the creation of the pouch, and (2) it occurs after a staple-line failure, developing a leak with an abscess, which then drains into the distal stomach forming the fistula. Early symptoms include fever, tachycardia, and abdominal pain. Failure in weight loss is a late clinical sign observed in these patients. Diagnosis is based on radiologic study, upper endoscopy and computed tomography. When identified in the acute postoperative course, laparoscopic treatment is easy. Chronic fistulas are difficult to manage, and the laparoscopic approach is an alternative to open surgery. Gastrogastric fistula is a possible complication of Roux-en-Y gastric bypass and its laparoscopic treatment is feasible.
ISSN:1086-8089
1938-3797