Endoscopic Double-Pigtail Catheter (EDPC) Internal Drainage as First-Line Treatment of Gastric Leak: A Case Series during Laparoscopic Sleeve Gastrectomy Learning Curve for Morbid Obesity

Lazzarin, Gianni; Furia, M.; Romano, Lucia; Sibio, Alessandra Di; Giacomo, Carla Di; Lombardi, Loreto; Giuliani, Antonio; Schietroma, Mario; Pessia, Beatrice; Carlei, F; Marchese, Michele

doi:10.1155/2020/8250904

Cited by 12 publications

(9 citation statements)

References 28 publications

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“…Patients with gastric leak may be totally asymptomatic or present symptoms of septic shock, such as fever, abdominal pain, tachycardia, tachypnoea and peritonitis [37]. The management of gastric leak is dependent on the clinical status of the patient and it includes: conservative treatment (withholding food and fluids, intravenous hydration, broad spectrum antibiotheraphy, and proton pump inhibitor administration), endoscopic intervention such as implementation of endoprothesis or endoscopic double-pigtail catheter (EDPC) or surgical management (lavage and drainage of peritoneal cavity) [38,39].…”

Section: Discussionmentioning

confidence: 99%

Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

Głuszyńska

Diemieszczyk

Szczerbiński

et al. 2022

JCM

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Background: Although laparoscopic sleeve gastrectomy (LSG) is considered a safe bariatric procedure in the treatment of obesity, it still involves a risk of developing postoperative complications. Knowledge of risk factors for possible complications would allow appropriate preoperative planning, optimization of postoperative care, as well as early diagnosis and treatment. The aim of this study was to evaluate risk factors for complications after laparoscopic sleeve gastrectomy. Methods: A retrospective study of 610 patients who underwent LSG at a tertiary institution were included in the study through retrospective analysis of the medical data. Complications were categorized as early (<30 days) and late (≥30 days) and evaluated according to the Clavien–Dindo Classification. Results: Early complications were observed in 35 patients (5.74%) and late complications occurred in 10 patients (1.64%). Independent risk factors of early complications after laparoscopic sleeve gastrectomy included hypercholesterolemia (OR 3.73; p-value = 0.023) and smoking (OR = 274.66, p-value < 0.001). Other factors that may influence the postoperative course are length of hospital stay and operation time. Smoking, peptic ulcer diseases and co-existence of hiatal hernia were found to be an independent predictors of late complications. Conclusions: Smoking is associated with the higher risk of both, early and late complications, while hypercholesterolemia with only <30 days complications after laparoscopic sleeve gastrectomy.

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Section: Discussionmentioning

confidence: 99%

Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

Głuszyńska

Diemieszczyk

Szczerbiński

et al. 2022

JCM

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“…Esophagectomy is more invasive than other gastrointestinal surgeries and is associated with infectious complications [ 30 ]. PCT is a predictor of infectious complications after esophagectomy.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of Procalcitonin as a Predictor of Long-Term Prognosis in the Early Postoperative Period after Esophagectomy for Esophageal Cancer

Booka

Kikuchi

Haneda

et al. 2022

JCM

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The aim of this study was to investigate the relationship between serum procalcitonin (PCT) levels after esophagectomy and infectious complications and long-term prognosis. A total of 105 patients who underwent esophagectomy between 2012 and 2019 were stratified into two groups: PCT-High group of ≥1 ng/mL and PCT-Low group of <1 ng/mL. The clinical outcomes and prognostic factors were compared between the two groups 2 postoperative days (POD), 4 POD, and 7 POD after esophagectomy. As the postoperative days passed, the association between PCT and infectious complications became stronger, and the positive predictive value was 100% at 7 POD. At 2 POD, there was no significant association between PCT elevation and infectious complications. Patients in the PCT-Low group had significantly worse overall survival (OS) and recurrence-free survival (RFS) than those in the PCT-High group at 2 POD (p = 0.026 and p = 0.011, respectively). In multivariate analysis, advanced pathological stage (hazard ratio (HR), 5.348; 95% confidence interval (CI), 2.299–12.500; p < 0.001) and PCT-Low group at 2 POD (HR, 3.673; 95% CI, 1.116–12.092; p = 0.032) were also independent predictors of worse OS. PCT in the early postoperative period after esophagectomy could be a good predictor of prognosis.

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“…This meta-analysis included 3 EVT [22, 23, 26] and 10 EID [9, 17-21, 24, 25, 27, 28] studies. EVT was employed in 47 patients.…”

Section: Resultsmentioning

confidence: 99%

Vacuum Therapy and Internal Drainage as the First-Line Endoscopic Treatment for Post-Bariatric Leaks: A Systematic Review and Meta-Analysis

et al. 2021

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Introduction: Several endoscopic methods can be employed to manage post-bariatric leaks. However, endoluminal vacuum therapy (EVT) and endoscopic internal drainage (EID) are relatively new methods, and studies regarding these methods are scarce. We performed a systematic review of the literature and a meta-analysis to evaluate the efficacy of EVT and EID. Methods: Databases were searched for eligible studies. The clinical success of leak closure was the primary outcome of interest. A proportional meta-analysis was performed for pooling the primary outcome using a fixed-effects model. A meta-analysis or descriptive analysis of other outcomes was performed based on the data availability. Results: Data from 3 EVT and 10 EID studies (n = 279) were used for evidence synthesis. The leak closure rates (95% confidence interval [CI]) of EVT and EID were 85.2% (75.1%–95.4%) and 91.6% (88.1%–95.2%), respectively. The corresponding mean treatment durations (95% CI) were 28 (2.4–53.6) and 78.4 (50.1–106.7) days, respectively. However, data about other outcomes were extremely limited; thus, a pooled analysis could not be performed. Conclusions: Both EVT and EID were effective when used as the first-line treatment for post-bariatric leaks. However, larger studies must be conducted to compare the efficacy of the 2 interventions.

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Endoscopic Double-Pigtail Catheter (EDPC) Internal Drainage as First-Line Treatment of Gastric Leak: A Case Series during Laparoscopic Sleeve Gastrectomy Learning Curve for Morbid Obesity

Cited by 12 publications

References 28 publications

Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

Risk Factors for Early and Late Complications after Laparoscopic Sleeve Gastrectomy in One-Year Observation

Usefulness of Procalcitonin as a Predictor of Long-Term Prognosis in the Early Postoperative Period after Esophagectomy for Esophageal Cancer

Vacuum Therapy and Internal Drainage as the First-Line Endoscopic Treatment for Post-Bariatric Leaks: A Systematic Review and Meta-Analysis

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