BACKGROUND: Revision surgery to eliminate a gastrogastric fistula (GGF) is often associated with high morbidity. METHODS: This report describes a percutaneous transgastric approach for revision surgery in three patients with GGF using a transgastric, totally extraperitoneal approach. RESULTS: The access was performed successfully in all the patients. There were no intraoperative complications, and the patients had an uneventful recovery. One patient had a recurrence 8 months after the procedure but had achieved satisfactory weight loss during the period. We were able to perform a second percutaneous transgastric repair. The second patient showed an asymptomatic recurrence of the fistula, which was later completely repaired. The third patient has had moderate weight loss. CONCLUSIONS: Although current results are not optimal, we believe that this approach could represent an alternative for patients with a hostile abdomen or in whom co-morbidities comprise a prohibitive factor. Further experience, technical improvements, and longer follow-up are needed to evaluate and optimize this approach and evaluate its potential use in other surgical areas.
BACKGROUND: Revision surgery to eliminate a gastrogastric fistula (GGF) is often associated with high morbidity. METHODS: This report describes a percutaneous transgastric approach for revision surgery in three patients with GGF using a transgastric, totally extraperitoneal approach. RESULTS: The access was performed successfully in all the patients. There were no intraoperative complications, and the patients had an uneventful recovery. One patient had a recurrence 8 months after the procedure but had achieved satisfactory weight loss during the period. We were able to perform a second percutaneous transgastric repair. The second patient showed an asymptomatic recurrence of the fistula, which was later completely repaired. The third patient has had moderate weight loss. CONCLUSIONS: Although current results are not optimal, we believe that this approach could represent an alternative for patients with a hostile abdomen or in whom co-morbidities comprise a prohibitive factor. Further experience, technical improvements, and longer follow-up are needed to evaluate and optimize this approach and evaluate its potential use in other surgical areas.
Authors: Elizabeth M Nesset; Michael L Kendrick; Scott G Houghton; Jane L Mai; Geoffrey B Thompson; Florencia G Que; Kristine M Thomsen; Dirk R Larson; Michael G Sarr Journal: Surg Obes Relat Dis Date: 2007 Jan-Feb Impact factor: 4.734
Authors: Tracey L Weigel; Darren C Schwartz; Jon C Gould; Patrick R Pfau Journal: Surg Laparosc Endosc Percutan Tech Date: 2005-06 Impact factor: 1.719
Authors: Alcides José Branco Filho; William Kondo; Luis Sérgio Nassif; Mariana Jorge Garcia; Rafael de Almeida Tirapelle; Carlos Marcelo Dotti Journal: JSLS Date: 2006 Jul-Sep Impact factor: 2.172