Lionel Rebibo1, Sami Hakim2, Franck Brazier2, Abdennaceur Dhahri1, Cyril Cosse3, Jean-Marc Regimbeau4. 1. Department of Digestive Surgery, Amiens University Hospital, Amiens, France. 2. Department of Gastroentrology, Amiens University Hospital, Amiens, France. 3. Department of Digestive Surgery, Amiens University Hospital, Amiens, France; Clinical Research Center, Amiens University Hospital, Amiens, France. 4. Department of Digestive Surgery, Amiens University Hospital, Amiens, France; Clinical Research Center, Amiens University Hospital, Amiens, France; EA4294, Jules Verne University of Picardie, Amiens, France. Electronic address: regimbeau.jean-marc@chu-amiens.fr.
Abstract
BACKGROUND: Covered stent (CS) is required when gastric leak (GL) after sleeve gastrectomy is combined with gastric stenosis (GS) or when a large (>2 cm in diameter) gastric fistula is present (increasing the likelihood of double pigtail stent [DPS] migration). OBJECTIVE: To compare the results of our previous endoscopic management of large GL or GS associated with GL (using CS only) with those of our new endoscopic treatment (using combined CS and DPS). SETTING: University hospital, France, public practice. MATERIAL AND METHODS: Between January 2009 and June 2015, all patients treated for large GL or GS associated with GL after sleeve gastrectomy (n = 20 patients) were included. Our previous endoscopic management required CS placement (CS group), whereas our new endoscopic treatment required combined CS and DPS placement (CS+DPS group). The primary efficacy endpoint was the treatment duration after CS placement until closure of the GL. The secondary efficacy endpoints were the number of endoscopic procedures, the stent migration rate, and the failure rate. RESULTS: Nine patients were treated by CS only (CS group), whereas 11 patients were treated by both CS and DPS (CS+DPS group). The median time to GL closure after CS placement was 84 days (33-130) in the CS group and 32 days (26-89) in the CS+DPS group (P≤.05). The median number of endoscopic procedures at the time of CS placement was 2 (1-3) in the CS group and 1 (1-2) in the CS+DPS group (P≤.05). The stent migration rate after CS placement was 33.3% in the CS group and 0% in the CS+DPS group (P = .21), and the failure rate was 11% and 0% (P = .36). CONCLUSION: The combination of CS and DPS constitutes an effective treatment for large GL or GS associated with GL, allowing significantly fewer endoscopic procedures and a shorter treatment duration. Copyright Â
BACKGROUND: Covered stent (CS) is required when gastric leak (GL) after sleeve gastrectomy is combined with gastric stenosis (GS) or when a large (>2 cm in diameter) gastric fistula is present (increasing the likelihood of double pigtail stent [DPS] migration). OBJECTIVE: To compare the results of our previous endoscopic management of large GL or GS associated with GL (using CS only) with those of our new endoscopic treatment (using combined CS and DPS). SETTING: University hospital, France, public practice. MATERIAL AND METHODS: Between January 2009 and June 2015, all patients treated for large GL or GS associated with GL after sleeve gastrectomy (n = 20 patients) were included. Our previous endoscopic management required CS placement (CS group), whereas our new endoscopic treatment required combined CS and DPS placement (CS+DPS group). The primary efficacy endpoint was the treatment duration after CS placement until closure of the GL. The secondary efficacy endpoints were the number of endoscopic procedures, the stent migration rate, and the failure rate. RESULTS: Nine patients were treated by CS only (CS group), whereas 11 patients were treated by both CS and DPS (CS+DPS group). The median time to GL closure after CS placement was 84 days (33-130) in the CS group and 32 days (26-89) in the CS+DPS group (P≤.05). The median number of endoscopic procedures at the time of CS placement was 2 (1-3) in the CS group and 1 (1-2) in the CS+DPS group (P≤.05). The stent migration rate after CS placement was 33.3% in the CS group and 0% in the CS+DPS group (P = .21), and the failure rate was 11% and 0% (P = .36). CONCLUSION: The combination of CS and DPS constitutes an effective treatment for large GL or GS associated with GL, allowing significantly fewer endoscopic procedures and a shorter treatment duration. Copyright Â
Authors: Ana Ponte; Rolando Pinho; Luísa Proença; Joana Silva; Jaime Rodrigues; Mafalda Sousa; João Carlos Silva; João Carvalho Journal: World J Gastrointest Endosc Date: 2017-06-16
Authors: Franck Billmann; Aylin Pfeiffer; Peter Sauer; Adrian Billeter; Christian Rupp; Ronald Koschny; Felix Nickel; Moritz von Frankenberg; Beat Peter Müller-Stich; Anja Schaible Journal: Obes Surg Date: 2021-11-03 Impact factor: 4.129
Authors: Hytham K S Hamid; Sameh H Emile; Alan A Saber; Mürşit Dincer; Diogo T H de Moura; Lennard P L Gilissen; Majid A Almadi; Mauro Montuori; Michel Vix; Luis G S Perisse; Nicolás Quezada; Fabio Garofalo; Radu Pescarus Journal: Surg Endosc Date: 2020-11-06 Impact factor: 4.584