- Journal of Experimental and Clinical Medicine
- Vol: 38 Issue: 3
- Endoscopic vacuum assisted closure of gastrocutaneous fistula after sleeve gastrectomy combined with...
Endoscopic vacuum assisted closure of gastrocutaneous fistula after sleeve gastrectomy combined with fibrin sealant
Authors : Jaroslaw Cwalinski, Jacek Hermann, Jacek Paszkowski, Tomasz Banasiewicz
Pages : 398-401
View : 8 | Download : 4
Publication Date : 2021-05-01
Article Type : Other
Abstract :Treatment of gastrointestinal fistulas after staple line leaks is difficult and non-invasive procedures such as endoclips, stents or endoscopic vacuum assisted closure (E-VAC) are sometimes not adequate. Fibrin sealants (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