The use of porcine acellular dermal matrix for management of gastrocutaneous fistula after laparoscopic sleeve gastrectomy.

Sleeve gastrectomy is an effective and single stand-alone surgical procedure for the treatment of morbid obesity. One of the most frequent and serious complications of this procedure is staple-line leak. It can usually be treated with self-expandable stents. If this process results in failure and gastrocutaneous fistula occurs, a challenging period starts for the patient and the surgeon. We describe a new, relatively simple and quick endoscopic technique for closing a chronic gastrocutaneous fistula. A plug prepared with porcine acellular dermal matrix was used for this purpose. Gastrocutaneous fistula following an obesity surgery can be successfully treated endoscopically with this technique. This method can prevent the need for aggressive reconstructive surgery following a gastrocutaneous fistula and can prompt rapid improvement while decreasing the average hospital stay for this condition.