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Empyema Caused by Gastropleural Fistula Post Complicated Laparoscopic Sleeve Gastrectomy

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Abstract

Gastropleural fistula (GPF) can occur as a rare complication of laparoscopic sleeve gastrectomy (LSG). Here, we present the clinical presentation, radiological findings, and outcome of a 19-year-old female who underwent LGS in Mother and Child Hospital in Shiraz, Iran, but due to leakage in the proximal of the stapler line, the operation converted to a single anastomosis sleeve ileal (SASI) bypass to decrease intraluminal pressure and accelerate healing of leakage site. Three months later, the patient admitted with the impression of empyema and diagnosed finally with a GPF. Although the conversion of LSG to SASI bypass for post leakage may be efficient in controlling the intraabdominal leakage, it will not prevent GPF formation, so applying another surgery method such as classic bypass in this situation may be more effective in the management of stapler line leakage.

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References

  1. Franco JV, Ruiz PA, Palermo M, et al. A review of studies comparing three laparoscopic procedures in bariatric surgery: sleeve gastrectomy, Roux-en-Y gastric bypass, and adjustable gastric banding. Obes Surg. 2011;21(9):1458–68.

    Article  Google Scholar 

  2. Lalor PF, Tucker ON, Szomstein S, et al. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2008;4(1):33–8.

    Article  Google Scholar 

  3. Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: a review of its prevention and management. World J Gastroenterol: WJG. 2014;20(38):13904–10.

    Article  Google Scholar 

  4. Csendes A, Burdiles P, Burgos AM, et al. Conservative management of anastomotic leaks after 557 open gastric bypasses. Obes Surg. 2005;15(9):1252–6.

    Article  Google Scholar 

  5. Alghanim F, Alkhaibary A, Alzakari A, et al. Gastropleural fistula as a rare complication of gastric sleeve surgery: a case report and comprehensive literature review. Case Rep Surg. 2018;1:2018.

    Google Scholar 

  6. Sobhani Z, Moein Vaziri N, Hosseini B, et al. Late gastropleural fistula after the management of laparoscopic sleeve gastrectomy leakage. Obes Surg. 2020;17:1–4.

    Google Scholar 

  7. Markowitz AM, Herter FP. Gastro-pleural fistula as a complication of esophageal hiatal hernia. Ann Surg. 1960;152(1):129–34.

    Article  CAS  Google Scholar 

  8. Al-shurafa H, Alghamdi S, Albenmousa A, et al. Gastropleural fistula after single anastomosis gastric bypass. A case report and review of the literature. Int J Surg Case Rep. 2017;35:82–6.

    Article  Google Scholar 

  9. Garcia-Quintero P, Hernandez-Murcia C, Romero R, et al. Gastropleural fistula after bariatric surgery: a report of two cases. J Robot Surg. 2015;9(2):163–6.

    Article  Google Scholar 

  10. Nguyen D, Dip F, Hendricks L, et al. The surgical management of complex fistulas after sleeve gastrectomy. Obes Surg. 2016;26(2):245–50.

    Article  Google Scholar 

  11. Mehran A, Ukleja A, Szomstein S, et al. Laparoscopic partial gastrectomy for the treatment of gastropleural fistula. JSLS. 2005;9(2):213–5.

    PubMed  PubMed Central  Google Scholar 

  12. Rogalski P, Swidnicka-Siergiejko A, Wasielica-Berger J, et al. Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis. Surg Endosc. 2020;27:1–21.

    Google Scholar 

  13. Luo RB, Liu S, DeLong JC, et al. Laparoscopic gastropleural fistula repair: a minimally invasive solution for a complex problem. J Laparoendosc Adv Surg Tech. 2017;27(4):416–9.

    Article  Google Scholar 

  14. Alazmi W, Al-Sabah S, Ali DA, et al. Treating sleeve gastrectomy leak with endoscopic stenting: the Kuwaiti experience and review of recent literature. Surg Endosc. 2014;28(12):3425–8.

    Article  Google Scholar 

  15. Ghanem OM, Dayyeh BK, Kellogg TA. Management of gastropleural fistula after revisional bariatric surgery: a hybrid laparoendoscopic approach. Obes Surg. 2017;27(10):2773–7.

    Article  Google Scholar 

  16. Trelles N, Gagner M, Palermo M, et al. Gastrocolic fistula after re-sleeve gastrectomy: outcomes after esophageal stent implantation. Surg Obes Relat Dis. 2010;6(3):308–12.

    Article  Google Scholar 

  17. Jiramethee N, Mira-Avendano I, Phelan J (2017) An unusual case of gastro-pleural fistula masquerading as pneumonia following bariatric surgery. InC52. CRITICAL CARE CASE REPORTS: UNUSUAL GI CAUSES OF CRITICAL ILLNESS (pp. A5807-A5807). American Thoracic Society

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Acknowledgments

We would like to show our gratitude to the staff of the Laparoscopy Research Center and Obesity Clinic, Shiraz Mother and Child Hospital, Iran, who helped and assisted this research.

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Authors and Affiliations

  1. Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Zahra Sobhani

  2. Department of Surgery, School of Medicine, Laparoscopy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Babak Hosseini, Nader MoeinVaziri, Ebrahim Kheradmand & Masood Amini

  3. Laparascopy Research Center, Ghadir Mother and Child Hospital, above gate Quran, First Town Gulshan, Shiraz, 71449-9537, Iran

    Masood Amini

  4. Obesity Prevention and Treatment Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

    Maryam Setoodeh

Authors
  1. Zahra Sobhani
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  2. Babak Hosseini
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  3. Nader MoeinVaziri
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  4. Ebrahim Kheradmand
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  5. Masood Amini
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  6. Maryam Setoodeh
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Corresponding author

Correspondence to Masood Amini.

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A written informed consent was obtained from the patient presented in the study.

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Sobhani, Z., Hosseini, B., MoeinVaziri, N. et al. Empyema Caused by Gastropleural Fistula Post Complicated Laparoscopic Sleeve Gastrectomy. OBES SURG 31, 895–898 (2021). https://doi.org/10.1007/s11695-020-04990-7

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  • DOI: https://doi.org/10.1007/s11695-020-04990-7

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