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. 2021 Jan;31(1):357-369.
doi: 10.1007/s11695-020-05078-y. Epub 2020 Oct 29.

Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options

Nasser Sakran  1   2 , Roxanna Zakeri  3 , Brijesh Madhok  4 , Yitka Graham  5   6   7 , Chetan Parmar  8 , Kamal Mahawar  5   7 , Sjaak Pouwels  9 ; Global Bariatric Research Collaborative
Affiliations

Gastric Fistula in the Chest After Sleeve Gastrectomy: a Systematic Review of Diagnostic and Treatment Options

Nasser Sakran et al. Obes Surg. 2021 Jan.

Abstract

This study aimed to establish the optimal diagnostic and treatment algorithm for the management of gastric fistula in the chest (GFIC) after sleeve gastrectomy (SG) through a systematic review of published cases. A multi-database search was performed, which produced 1182 results, of which 26 studies were included in this systematic review. The initial presentation included subphrenic collections, leaks, or (recurrent) pneumonia with associated symptoms such as persistent cough, fever, and/or dyspnea. Computed tomography (CT) scan in combination with either upper gastrointestinal (UGI) series or an esophagogastroduodenoscopy (EGD) was used to adequately diagnose the fistulas. Initial treatment was either with clips and/or clips and stents that were placed endoscopically. When unsuccessful in the majority of the cases, the surgical treatment consisted of total gastrectomy and Roux-en-Y esophagojejunostomy in a laparoscopic or open fashion.

Keywords: Bariatric surgery; Gastro-bronchial fistula; Gastro-pleural fistula; Gastro-pulmonary fistula; Sleeve gastrectomy.

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