Endoscopic vacuum assisted closure of gastrocutaneous fistula after sleeve gastrectomy combined with fibrin sealant

Authors : Jaroslaw CWALİNSKİ, Jacek HERMANN, Jacek PASZKOWSKİ, Tomasz BANASİEWİCZ

Pages : 398-401

View : 131 | Download : 9

Publication Date : 2021-05-01

Article Type : Other Papers

Abstract :Treatment of gastrointestinal fistulas after staple line leaks is difficult and non-invasive procedures such as endoclips, stents or endoscopic vacuum assisted closure insert ignore into journalissuearticles values(E-VAC); are sometimes not adequate. Fibrin sealants insert ignore into journalissuearticles values(FS); may promote healing, although today are used mainly to prevent anastomosis dehiscence within digestive tract. The authors present a 37-year old female patient who developed a chronic gastrocutaneous fistula after sleeve gastrectomy for severe obesity treated successfully with a combination of E-VAC and a fibrin sealant. Long term peritoneal drainage, total parenteral nutrition, and antibiotic therapy for the next six weeks failed to close the leakage. Ultimately the fistula was closed after 6 changes of E-VAC and final implementation of a fibrin sealant. The duration of treatment was 81 days, including 34 days of E-VAC treatment and FS application. Complete closure of the fistula was visualized on gastroscopy 6 weeks after the treatment.
Keywords : E VAC, tissue sealant, gastrocutaneous fistua

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