Effective and alternative treatment of anastomotic leak after gastrojejunal bypass: endoluminal vacuum therapy

Anastomotic leak (AL) after with Roux-en-Y gastric bypass (RYGB) has a morbidity rate to 53% and it can be potentially lethal (mortality rate from 0.5 to 10%). In these cases, surgery is usually a challenge, so in recent years minimally invasive endoscopic treatment is gaining ground. Endoluminal va...

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Bibliographic Details
Published in:	Revista española de enfermedades digestivas Vol. 116; no. 1; p. 52
Main Authors:	de Armas Conde, María, Rojas Estévez, Marta, Díaz López, Carmen, Concepción Martín, Vanessa, Gianchandani Moorjani, Rajesh, Borque Barrera, María Del Pilar, García Romero, Diana María, Moneva Arce, Modesto Enrique
Format:	Journal Article
Language:	English
Published:	Spain 01-01-2024
Subjects:	Anastomotic Leak - surgery Bariatric Surgery Endoscopy, Gastrointestinal Gastric Bypass - adverse effects Humans Male Negative-Pressure Wound Therapy Obesity, Morbid - surgery Retrospective Studies
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Summary:	Anastomotic leak (AL) after with Roux-en-Y gastric bypass (RYGB) has a morbidity rate to 53% and it can be potentially lethal (mortality rate from 0.5 to 10%). In these cases, surgery is usually a challenge, so in recent years minimally invasive endoscopic treatment is gaining ground. Endoluminal vacuum therapy (EVAC) is a promising treatment that is being used in esophagogastric and rectal surgery for the management of AL. We present the case of a patient on his 5th postoperative day of bariatric surgery (RYGB) with an acute abdomen. He was diagnosed of dehiscence of gastrojejunal anastomosis and he needed urgent surgery twice. Subsequently, in control CT, a new anastomotic leak is evidenced. However, given the clinical stability of the patient, it was decided to start EVAC type ESO-Sponge® placed by endoscopy. A total of 4 changes are made every 3-4 days with a total duration of treatment of 15 days. EVAC was removed when the defect presented a 1 mm sized.
Bibliography:	ObjectType-Case Study-2 SourceType-Scholarly Journals-1 ObjectType-Feature-4 content type line 23 ObjectType-Report-1 ObjectType-Article-3
ISSN:	1130-0108
DOI:	10.17235/reed.2023.9675/2023