ASGE DDW Videos from Around the World | 2023-A NOVEL 2 STAGED APPROACH FOR THE MANAGEMENT OF REFRACTORY COMPLEX LEAKS AND FISTULAS POST LAPAROSCOPIC SLEEVE GASTRECTOMY

A NOVEL 2 STAGED APPROACH FOR THE MANAGEMENT OF REFRACTORY COMPLEX LEAKS AND FISTULAS POST LAPAROSCOPIC SLEEVE GASTRECTOMY

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Video Transcription

Video Summary

The video describes a case of a 61-year-old female who presented with a refractory gastric leak in fistula formation after laparoscopic sleeve gastrectomy. Various therapeutic approaches were attempted but failed, leading to the development of abscesses and sepsis. A two-staged approach was devised to manage the leak. In the first stage, an obtruded peg bumper was used to create negative pressure within the abscess cavity, followed by the insertion of a double pigtail catheter. In the second stage, a self-expanding vascular plug was placed through the fistula tract using fluoroscopy. The patient experienced improvement and planned surgery was canceled. The approach highlights the importance of considering underlying pathophysiology and using innovative solutions for refractory leaks and fistulas following sleeve gastrectomy.

Asset Subtitle

Video Plenary
Authors: Aya Akhras, Fnu Deepali, Anmol Bains, Yadwinder Singh, Trenton Hinkley, Navtej S. Buttar

Keywords

refractory gastric leak

fistula formation

laparoscopic sleeve gastrectomy

abscesses and sepsis

two-staged approach