Ezzy Mohsen, Schriener Thomas, Weiner Sylvia, Elshafei Moustafa
Department of Obesity and Metabolic Surgery, Nordwest Hospital, Frankfurt, 60488, Germany.
Int J Surg Case Rep. 2021 Feb;79:394-397. doi: 10.1016/j.ijscr.2021.01.083. Epub 2021 Jan 22.
Postsleeve gastrectomy fistula is a serious complication, and its management remains quite challenging. The clinical presentation of chronic fistula after sleeve gastrectomy (SG) varies widely and depends on the type of fistula. Management requires a multidisciplinary approach and patient cooperation.
We present a case of a 41-year-old woman with a body mass index (BMI) of 46 kg/m who initially underwent laparoscopic sleeve gastrectomy in our hospital. Later, she developed a gastro-colo-diaphragmatic fistula (GCD), which was successfully treated using an endolaparoscopic approach. Follow-up imaging and endoscopy showed complete healing of the fistula, as well as a marked clinical improvement of the patient.
Gastro-colo-diaphragmatic fistula following sleeve gastrectomy is an extremely rare complication. This is the first case of a GCD fistula after sleeve gastrectomy that has been reported in the literature.
One staged endolaparoscopic management was successful approach in our case and can be considered for complex gastric fistula following sleeve gastrectomy.
袖状胃切除术后瘘是一种严重的并发症，其治疗仍然颇具挑战性。袖状胃切除术后慢性瘘的临床表现差异很大，取决于瘘的类型。治疗需要多学科方法和患者的配合。
我们报告一例41岁女性患者，其体重指数（BMI）为46kg/m²，最初在我院接受了腹腔镜袖状胃切除术。后来，她出现了胃-结肠-膈瘘（GCD），通过腹腔镜内镜方法成功治疗。随访影像学检查和内镜检查显示瘘完全愈合，患者临床症状明显改善。
袖状胃切除术后胃-结肠-膈瘘是一种极其罕见的并发症。这是文献中报道的首例袖状胃切除术后GCD瘘病例。
在我们的病例中，一期腹腔镜内镜治疗是成功的方法，对于袖状胃切除术后复杂的胃瘘可考虑采用。
