A Case of Endoscopic Closure to Postoperative Leak after Laparoscopic Sleeve Gastrectomy in Patient with Morbid Obesity.
10.12771/emj.2013.36.2.135
- Author:
Min Sun RYU
1
;
Ki Nam SHIM
;
Won Young CHO
;
Chan Young KIM
;
Hyeon Ju KANG
;
Mi Yeon KIM
;
So Young AHN
;
Yoon Pyo LEE
;
Hyoung Won CHO
;
Sung Ae JUNG
;
Joo Ho LEE
Author Information
1. Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea. shimkn@ewha.ac.kr
- Publication Type:Case Report
- Keywords:
Fibrin tissue adhesive;
Fistula;
Gastrectomy;
Obesity;
Stent
- MeSH:
Adult;
Body Mass Index;
Diabetes Mellitus, Type 2;
Drainage;
Endoscopy, Digestive System;
Esophagogastric Junction;
Female;
Fibrin Tissue Adhesive;
Fistula;
Gastrectomy*;
Humans;
Hypertension;
Obesity;
Obesity, Morbid*;
Physical Examination;
Stents
- From:The Ewha Medical Journal
2013;36(2):135-138
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Laparoscopic sleeve gastrectomy can reduce morbidity and mortality in patients with morbid obesity, but it can cause complications such as a gastrointestinal leak. A 30-year-old morbidly obese female who had type 2 diabetes mellitus and hypertension with estimated body mass index of 40.2 kg/m2 was admitted. Laparoscopic sleeve gastrectomy was performed. On postoperative day 19, a leak was suspicious on physical examination and radiologic findings. Conservative management was performed, but the patient was hemodynamically unstable and imminently septic. After laparoscopic drainage procedure, esophagogastroduodenoscopy was performed and revealed the fistula opening at staple line just below gastroesophageal junction. Fibrin tissue adhesive was injected around the fistula and the esophageal covered stent was inserted to cover the leak. At 14th days after stent insertion, the barium study confirmed no more leak. In this case, we experienced that the esophageal stent insertion with fibrin tissue adhesive injection may reduce recovery time of the fistula developed after laparoscopic sleeve gastrectomy.
