Endoscopy 2020; 52(S 01): S153
DOI: 10.1055/s-0040-1704470
ESGE Days 2020 ePoster Podium presentations
Friday, April 24, 2020 09:00 – 09:30 Upper GI: Management of complications 2 ePoster Podium 1
© Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC TREATMENT OF EARLY LEAKS AND STRICTURES AFTER LAPAROSCOPIC ONE ANASTOMOSIS GASTRIC BYPASS

F Younis
1   Tel Aviv Sourasky Medical Center, Gastroenterology and Liver Diseases, Tel Aviv, Israel
,
M Shnell
1   Tel Aviv Sourasky Medical Center, Gastroenterology and Liver Diseases, Tel Aviv, Israel
,
N Gluck
1   Tel Aviv Sourasky Medical Center, Gastroenterology and Liver Diseases, Tel Aviv, Israel
,
S Abu-abeid
2   Tel Aviv Sourasky Medical Center, Bariatric Unit, Department of Surgery, Tel Aviv, Israel
,
S Eldar
2   Tel Aviv Sourasky Medical Center, Bariatric Unit, Department of Surgery, Tel Aviv, Israel
,
S Fishman
1   Tel Aviv Sourasky Medical Center, Gastroenterology and Liver Diseases, Tel Aviv, Israel
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Publikationsverlauf

Publikationsdatum:
23. April 2020 (online)

 
 

    Aims To summarize our experience with endoscopic treatment of laparoscopic one anastomosis gastric bypass complications.

    Methods This is a retrospective study of consecutive patients referred to our hospital from 2015 to 2017 with post laparoscopic one anastomosis gastric bypass complications. Therapy was tailored to each case, including fully covered self-expandable metal stents, fibrin glue, septotomy, internal drainage with pigtail stents, through-the-scope and pneumatic dilation. Success was defined as resuming oral nutrition without enteral or parenteral support or further surgical intervention.

    Results Nine patients presented with acute or early leaks: 5 (56%) had staple-line leaks, 3 (33%) had anastomotic leaks and 1 (11%) had both. All were treated with stents. Adjunctive endoscopic drainage was applied in 4 patients (44%). Overall 5 patients (56%) with acute/early leaks recovered completely, including all 3 patients with anastomotic leak and the patient with both leaks but only 1/5 with staple line leak (20%). Complication rate in the leak group reached 22%. Eight patients presented with strictures, 7 at the anastomosis and one due to remnant stomach misalignment. All anastomotic strictures were dilated successfully. However, the patient with the pouch stricture required conversion to Roux-en-Y gastric bypass after 3 failed attempts of dilatation.

    Conclusions Endoscopic treatments of laparoscopic one anastomosis gastric bypass complications are relatively effective and safe. Anastomosis-related complications are more amenable to endoscopic treatment compared to staple line leaks.


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