https://scholars.lib.ntu.edu.tw/handle/123456789/540935
標題: | Endoluminal stenting for the management of leak following sleeve gastrectomy and loop duodenojejunal bypass with sleeve gastrectomy | 作者: | Tsai Y.-N. HSIU-PO WANG Huang C.-K. Chang P.-C. Lin I.-C. Tai C.-M. |
關鍵字: | Bariatric surgery; Endoluminal stenting; Leak; Metal stents; Sleeve gastrectomy | 公開日期: | 2018 | 出版社: | Elsevier (Singapore) Pte Ltd | 卷: | 34 | 期: | 1 | 起(迄)頁: | 43-48 | 來源出版物: | Kaohsiung Journal of Medical Sciences | 摘要: | Postoperative leak is a serious complication of bariatric surgery and often results in significant morbidity and mortality. Stent placement is a less invasive alternative to surgery for the treatment of bariatric surgical leak. We evaluated the efficacy and complications of covered self-expandable metal stents (SEMS) in the treatment of post-bariatric surgical leak. We retrospectively reviewed patients who underwent stent placement for leak after bariatric surgery. Leak was diagnosed by upper gastrointestinal series or was visualized during the endoscopy. We examined the timing of stent placement, size of the leak, stent migration and its complications, total stent treatment duration, and treatment outcome. Between January 2011 and April 2015, seven patients underwent covered SEMS placement for leak after bariatric surgery, including laparoscopic sleeve gastrectomy (LSG) (n = 5) and laparoscopic loop duodenojejunal bypass with sleeve gastrectomy (LDJB-SG) (n = 2). A stent was placed in one patient for infection control and bridging to revisional surgery. Among the other six patients, one patient who received stent placement one year after leak diagnosis failed to achieve leak closure, and five patients with early stent placement achieved leak closure. Three patients with small leak achieved leak closure more quickly. Stent migration was found in six patients, and associated ulcers occurred in five patients. We conclude that stenting is effective in the management of staple-line leaks following LSG and LDJB-SG. Stent migration and associated ulcers are common after stent placement. Early stent removal can be achieved in patients with small leaks. ? 2017 |
URI: | https://www.scopus.com/inward/record.uri?eid=2-s2.0-85028619107&doi=10.1016%2fj.kjms.2017.08.004&partnerID=40&md5=72edcf11499c3f3af8a021a3e0910d43 https://scholars.lib.ntu.edu.tw/handle/123456789/540935 |
ISSN: | 1607-551X | DOI: | 10.1016/j.kjms.2017.08.004 | SDG/關鍵字: | adult; Article; bariatric surgery; device therapy; esophagogastroduodenoscopy; female; human; infection control; intestine bypass; laparoscopic loop duodenojejunal bypass; laparoscopic loop duodenojejunal bypass with sleeve gastrectomy; laparoscopic sleeve gastrectomy; major clinical study; male; middle aged; postoperative complication; reoperation; retrospective study; sleeve gastrectomy; stent complication; stent migration; surgical leak; treatment duration; treatment outcome; upper gastrointestinal tract; anastomosis; anastomosis leakage; digestive tract endoscopy; duodenum; gastrectomy; jejunum; morbid obesity; pathology; procedures; stent; surgical stapling; Adult; Anastomosis, Surgical; Anastomotic Leak; Bariatric Surgery; Duodenum; Endoscopy, Digestive System; Female; Gastrectomy; Humans; Jejunum; Male; Middle Aged; Obesity, Morbid; Retrospective Studies; Stents; Surgical Stapling; Treatment Outcome |
顯示於: | 醫學系 |
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