Year 2021 / Volume 113 / Number 10
Original
Endoscopic internal drainage using transmural double-pigtail stents in leaks following upper gastrointestinal tract surgery

698-703

DOI: 10.17235/reed.2020.7514/2020

Esteban Fuentes-Valenzuela, Francisco Javier García-Alonso, Javier Tejedor-Tejada, Rodrigo Nájera-Muñoz, Marina de Benito Sanz, Ramón Sánchez-Ocaña, Carlos de la Serna Higuera, Manuel Pérez-Miranda,

Abstract
Introduction: different endoscopic procedures have been proposed for the management of surgical leaks. Endoscopic internal drainage using trans-fistulary double-pigtail plastic stents has emerged as an alternative strategy, especially in fistulae presenting after laparoscopic gastric sleeve. Methods: a retrospective case series was performed at a single tertiary care center including all upper gastrointestinal post-surgical leaks primarily managed with endoscopic trans-fistulary insertion of double-pigtail plastic stents. Clinical success was defined as the absence of extravasation of oral radiographic contrast and radiological resolution of the collection with adequate oral intake Results: nine patients were included, six (66.6 %) females with a median age of 52.6 years (IQR 47-60). Five cases presented after laparoscopic gastric sleeve, two cases after distal esophagectomies, one after a Roux-en-Y gastric bypass and another one after a pancreaticoduodenectomy. Fistulae measured < 10 mm in five patients (55.6 %) and 10-20 mm in four patients (44.4 %). Six were early leaks. Technical and clinical success was achieved in nine (100 %) and seven (77.8 %) cases, respectively. Seven (77.8 %) patients required ≤ 3 endoscopic procedures. The median hospital stay after the first endoscopic procedure was 12 days (IQR 6.5-17.5 days), while the overall median time until leak healing was 118.5 days (IQR 84.5-170). One patient with a post-esophagectomy intrathoracic leak developed an esophageal-tracheal fistula 37 days after stent deployment. Conclusions: our results support the use of endoscopic internal drainage in postsurgical abdominal leaks, regardless of the type of surgery. Although only two patients with intrathoracic dehiscence were included.
Share Button
New comment
Comments
No comments for this article
Citation tools
Fuentes-Valenzuela E, García-Alonso F, Tejedor-Tejada J, Nájera-Muñoz R, de Benito Sanz M, Sánchez-Ocaña R, et all. Endoscopic internal drainage using transmural double-pigtail stents in leaks following upper gastrointestinal tract surgery. 7514/2020


Download to a citation manager

Download the citation for this article by clicking on one of the following citation managers:

Metrics
This article has received 2240 visits.
This article has been downloaded 338 times.

Statistics from Dimensions


Statistics from Plum Analytics

Publication history

Received: 08/09/2020

Accepted: 16/11/2020

Online First: 29/12/2020

Published: 06/10/2021

Article revision time: 63 days

Article Online First time: 112 days

Article editing time: 393 days


Share
This article has been rated by 1 readers.
Reader rating:
Valora este artículo:




Asociación Española de Ecografía Digestiva Sociedad Española de Endoscopia Digestiva Sociedad Española de Patología Digestiva
The Spanish Journal of Gastroenterology is the official organ of the Sociedad Española de Patología Digestiva, the Sociedad Española de Endoscopia Digestiva and the Asociación Española de Ecografía Digestiva
Cookie policy Privacy Policy Legal Notice © Copyright 2023 y Creative Commons. The Spanish Journal of Gastroenterology