Stemming the Leak: A Novel Treatment for Gastro-Bronchial Fistula

Mongardini, Federico Maria; Cacciatore, Christopher J; Catauro, A.; Maglione, F.; Picardi, F.; Lauro, A.; Gambardella, C.; Allaria, A.; Docimo, L.

doi:10.1007/s10620-022-07711-5

Cited by 3 publications

(2 citation statements)

References 26 publications

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“…Recently, there is a reported noval treatment for post-LSG broncho-gastric fistula with application of autologous stem cells after the failure of the conventional surgical/endoscopic approach. 15 In conclusion, management of GBF should be individualized to each case, however surgical approaches carry a high mortality rate, therefore, endoscopic therapy through different strategies is a highly effective therapeutic option and should be implemented early in order to shorten leakage healing time.…”

Section: Case Presentationmentioning

confidence: 99%

Gastrobronchial fistula: A rare complication after laparoscopic sleeve gastrectomy and its endoscopic management.

Abdel-latif,

Elgawish,

Elsefy

et al. 2024

Global Gastroenterology

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Background: Bariatric surgery is considered the standard of care for morbid obese patients who failed conservative management. However, it's not free of complications. Gastrobronchial fistula (GBF) is one of complications that could be happened during the post-operative course that could be successfully managed either surgically or endoscopically. Case presentation: We present a case of 45 years old morbid obese female patient underwent gastric bypass surgery that was early complicated by gastric leakage that was managed endoscopically with OVESCO clipping. 6 years later, the patient presented with chest infection with coughing of food that was proved to be associated with gastrobronchial fistula. We applied OVESCO clips and closed the fistula and dilate the gastrojejunostomy due to very narrow gastrojejunostomy using a balloon 20 to 30 mm and dilatation was done several times. After that repeated the barium meal showed that the fistula was successfully closed. Conclusion: Gastrobronchial fistula is one of rare reported complications following bariatric surgery that could be successfully managed endoscopically through different strategies in a highly effective therapeutic option that help in shortening of the leakage healing time.

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Section: Case Presentationmentioning

confidence: 99%

Gastrobronchial fistula: A rare complication after laparoscopic sleeve gastrectomy and its endoscopic management.

Abdel-latif,

Elgawish,

Elsefy

et al. 2024

Global Gastroenterology

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“…The same technique has also been applied for successful closure of a gastro-bronchial fistula after a 25 mm leak at a laparoscopic sleeve gastrectomy suture line, followed by a huge fluid collection in the left subphrenic area, communicated with another intrapulmonary collection [84].…”

Section: Stem Cellsmentioning

confidence: 99%

Endoscopic Salvage of Gastrointestinal Anastomosis Leaks—Past, Present, and Future—A Narrated Review

Menni,

Stavrou,

Tzikos

et al. 2023

Gastrointestinal Disorders

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Background: Anastomotic leakage, which is defined as a defect in the integrity of a surgical join between two hollow viscera leading to communication between the intraluminal and extraluminal compartments, continues to be of high incidence and one of the most feared complications following gastrointestinal surgery, with a significant potential for a fatal outcome. Surgical options for management are limited and carry a high risk of morbidity and mortality; thus, surgeons are urged to look for alternative options which are minimally invasive, repeatable, non-operative, and do not require general anesthesia. Methods: A narrative review of the international literature took place, including PubMed, Scopus, and Google Scholar, utilizing specific search terms such as “Digestive Surgery AND Anastomotic Leakage OR leak OR dehiscence”. Results: In the present review, we try to describe and analyze the pros and cons of the various endoscopic techniques: from the very first (and still available), fibrin gluing, to endoclip and over-the-scope clip positioning, stent insertion, and the latest suturing and endoluminal vacuum devices. Finally, alongside efforts to improve the existing techniques, we consider stem cell application as well as non-endoscopic, and even endoscopic, attempts at intraluminal microbiome modification, which should ultimately intervene pre-emptively, rather than therapeutically, to prevent leaks. Conclusions: In the last three decades, this search for an ideal device for closure, which must be safe, easy to deploy, inexpensive, robust, effect rapid and stable closure of even large defects, and have a low complication rate, has led to the proposal and application of a number of different endoscopic devices and techniques. However, to date, there is no consensus as to the best. The literature contains reports of only small studies and no randomized trials, failing to take into account both the heterogeneity of leaks and their different anatomical sites.

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