Department of Upper GI and Bariatric Surgery, Whittington Health NHS Trust, Magdala Ave, London, N19 5NF, UK.
Barts Health NHS Trust, London, EC1A 7BE, UK.
Obes Surg. 2023 Nov;33(11):3658-3668. doi: 10.1007/s11695-023-06861-3. Epub 2023 Oct 7.
Gastrocutaneous fistula (GCF) is a devastating complication that can arise after bariatric and metabolic surgery (BMS). This systematic review examines the success rate of closure techniques of GCF. A systematic search was conducted across MEDLINE, Embase and Cochrane databases to identify studies which reported on closure techniques of GCF after BMS in adults. Thirty-three studies (n = 108 patients) were included. Seventeen different techniques were used to close GCF across all studies. The most popular were stents (n = 17), tissue sealants (n = 12) and over-the-scope clips (n = 11). Twenty-one studies used multiple techniques to attempt closure, including endoscopic vacuum therapy and revisional surgery. This systematic review demonstrates current practice focusing on endoscopic methods such as stents and over-the-scope clips, with relative success in closing GCF.
胃皮瘘（GCF）是一种严重的并发症，可能在减重和代谢手术（BMS）后出现。本系统评价检查了 GCF 闭合技术的成功率。系统检索了 MEDLINE、Embase 和 Cochrane 数据库，以确定报告 BMS 后成人 GCF 闭合技术的研究。共纳入 33 项研究（n=108 例患者）。所有研究中使用了 17 种不同的技术来闭合 GCF。最常用的是支架（n=17）、组织密封剂（n=12）和过镜夹（n=11）。21 项研究使用了多种技术来尝试闭合，包括内镜下真空治疗和修正手术。本系统评价显示，目前的实践重点是内镜方法，如支架和过镜夹，在闭合 GCF 方面取得了相对成功。
