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Endoscopic Treatment of Complications After Bariatric Surgery

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Obesity, Bariatric and Metabolic Surgery

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Abstract

With increasing prevalence of obesity and its related comorbidities, there has been a steep rise in the number of bariatric procedures throughout the world. Clearly, this has resulted in a growth in the number of complications unique to bariatric surgery. There is a need to treat these complications in a minimally invasive way. Thus, technically advanced endoscopic procedures have come into practice, known as “bariatric endoscopy,” an interface between bariatric surgery and advanced therapeutic endoscopy.

Surgical treatment of complications may lead to increased morbidity. Therefore, it is being replaced by minimally invasive endoluminal endoscopic procedures, especially to control conditions such as infection, fistula, stenosis, food impaction, ring and band erosion, bleeding, and choledocholithiasis. Endoscopic approach has shown a progressive increasing role in treating these complications.

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References

  1. Ardila-Gatas J, Pryor A. Endoscopic approach for the treatment of bariatric surgery complications. Mini-invasive Surg. 2020;4:16.

    Google Scholar 

  2. Boules M, Chang J, Haskins IN, Sharma G, Froylich D, El-Hayek K, Rodriguez J, Kroh M. Endoscopic management of post-bariatric surgery complications. World J Gastrointest Endosc. 2016;8(17):591–9.

    Article  Google Scholar 

  3. Kumar N, Thompson CC. Endoscopic management of complications after gastrointestinal weight loss surgery. Clin Gastroenterol Hepatol. 2013;11(4):343–53.

    Article  Google Scholar 

  4. Egberts K, Brown WA, O’Brien PE. Systematic review of erosion after laparoscopic adjustable gastric banding. Obes Surg. 2011;21(8):1272–9.

    Article  Google Scholar 

  5. Campos JM, Galvão Neto MP, Moura EGH. Endoscopia em cirurgia da obesidade. 1st ed. São Paulo: Santos; 2008.

    Google Scholar 

  6. Neto MP, Ramos AC, Campos JM, Murakami AH, Falcao M, Moura EH, et al. Endoscopic removal of eroded adjustable gastric band: lessons learned after 5 years and 78 cases. Surg Obes Relat Dis. 2010;6(4):423–7.

    Article  Google Scholar 

  7. Miranda da Rocha LC, Ayub Pérez OA, Arantes V. Endoscopic management of bariatric surgery complications: what the gastroenterologist should know. Rev Gastroenterol Mex. 2016;81(1):35–47.

    CAS  Google Scholar 

  8. Boru C, Silecchia G. Bariatric emergencies: what the general surgeon should know. Chirurgia. 2010;105(4):455–64.

    CAS  Google Scholar 

  9. Ginsberg GG. Management of ingested foreign objects and food bolus impactions. Gastrointest Endosc. 1995;41(1):33–8.

    Article  CAS  Google Scholar 

  10. Conway WC, Sugawa C, Ono H, Lucas CE. Upper GI foreign body: an adult urban emergency hospital experience. Surg Endosc. 2007;21(3):455–60.

    Article  CAS  Google Scholar 

  11. Ben-Porat T, Sherf Dagan S, Goldenshluger A, Yuval JB, Elazary R. Gastrointestinal phytobezoar following bariatric surgery: systematic review. Surg Obes Relat Dis. 2016;12(9):1747–54.

    Article  Google Scholar 

  12. Sapala JA, Wood MH, Sapala MA, Flake TM Jr. Marginal ulcer after gastric bypass: a prospective 3-year study of 173 patients. Obes Surg. 1998;8(5):505–16.

    Article  CAS  Google Scholar 

  13. El-Hayek K, Timratana P, Shimizu H, Chand B. Marginal ulcer after Roux-en-Y gastric bypass: what have we really learned? Surg Endosc. 2012;26(10):2789–96.

    Article  CAS  Google Scholar 

  14. Campos JM, Mello FS, Ferraz AA, Brito JN, Nassif PA, Galvao-Neto MP. Endoscopic dilation of gastrojejunal anastomosis after gastric bypass. Arq Bras Cir Dig. 2012;25(4):283–9.

    Article  Google Scholar 

  15. Espinel J, Pinedo E. Stenosis in gastric bypass: endoscopic management. World J Gastrointest Endosc. 2012;4(7):290–5.

    Article  Google Scholar 

  16. Falcao M, Campos JM, Galvao Neto M, Ramos A, Secchi T, Alves E, et al. Transgastric endoscopic retrograde cholangiopancreatography for the management of biliary tract disease after Roux-en-Y gastric bypass treatment for obesity. Obes Surg. 2012;22(6):872–6.

    Article  Google Scholar 

  17. Chu YC, Yang CC, Yeh YH, Chen CH, Yueh SK. Double-balloon enteroscopy application in biliary tract disease – its therapeutic and diagnostic functions. Gastrointest Endosc. 2008;68(3):585–91.

    Article  Google Scholar 

  18. Galvão Neto MP, Campos JM, Garrido T. Endoscopia en cirugía de la obesidad. Caracas: AMOLCA; 2008.

    Google Scholar 

  19. Campos JM, Galvão Neto MP, Ramos A, Dib R. Endoscopia bariátrica terapêutica. 1st ed. São Paulo: Revinter; 2014.

    Google Scholar 

  20. Campos JM, Evangelista LF, Ferraz AA, Galvao Neto MP, De Moura EG, Sakai P, et al. Treatment of ring slippage after gastric bypass: long-term results after endoscopic dilation with an achalasia balloon (with videos). Gastrointest Endosc. 2010;72(1):44–9.

    Article  Google Scholar 

  21. Ferraz A, Campos J, Dib V, Silva LB, de Paula PS, Gordejuela A, et al. Food intolerance after banded gastric bypass without stenosis: aggressive endoscopic dilation avoids reoperation. Obes Surg. 2013;23(7):959–64.

    Article  Google Scholar 

  22. Marins Campos J, Moon RC, Magalhaes Neto GE, Teixeira AF, Jawad MA, Bezerra Silva L, et al. Endoscopic treatment of food intolerance after a banded gastric bypass: inducing band erosion for removal using a plastic stent. Endoscopy. 2016;48(6):516–20.

    Article  Google Scholar 

  23. Blero D, Eisendrath P, Vandermeeren A, Closset J, Mehdi A, Le Moine O, et al. Endoscopic removal of dysfunctioning bands or rings after restrictive bariatric procedures. Gastrointest Endosc. 2010;71(3):468–74.

    Article  Google Scholar 

  24. Wilson TD, Miller N, Brown N, Snyder BE, Wilson EB. Stent induced gastric wall erosion and endoscopic retrieval of nonadjustable gastric band: a new technique. Surg Endosc. 2013;27(5):1617–21.

    Article  Google Scholar 

  25. Campos JM, Pereira EF, Evangelista LF, Siqueira L, Neto MG, Dib V, et al. Gastrobronchial fistula after sleeve gastrectomy and gastric bypass: endoscopic management and prevention. Obes Surg. 2011;21(10):1520–9.

    Article  Google Scholar 

  26. Campos JM, Siqueira LT, Ferraz AA, Ferraz EM. Gastrobronchial fistula after obesity surgery. J Am Coll Surg. 2007;204(4):711.

    Article  Google Scholar 

  27. Buchwald H, Avidor Y, Braunwald E, Jensen MD, Pories W, Fahrbach K, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.

    Article  CAS  Google Scholar 

  28. Puli SR, Spofford IS, Thompson CC. Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis. Gastrointest Endosc. 2012;75(2):287–93.

    Article  Google Scholar 

  29. Rosenthal RJ, International Sleeve Gastrectomy Expert Panel, Diaz AA, Arvidsson D, Baker RS, Basso N, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8(1):8–19.

    Article  Google Scholar 

  30. Iossa A, Abdelgawad M, Watkins BM, Silecchia G. Leaks after laparoscopic sleeve gastrectomy: overview of pathogenesis and risk factors. Langenbeck’s Arch Surg. 2016;401(6):757–66.

    Article  Google Scholar 

  31. Galvão Neto M, Rodriguez L, Zundel N, Ayala JC, Campos J, Ramos A. Endoscopic revision of Roux-en-Y gastric bypass stomal dilation with a suturing device: preliminary results of a first out-of-United-States series. Bariatric Times. 2011;8(6):32–34.

    Google Scholar 

  32. Pickhardt PJ, Bhalla S, Balfe DM. Acquired gastrointestinal fistulas: classification, etiologies, and imaging evaluation. Radiology. 2002;224(1):9–23.

    Article  Google Scholar 

  33. Spyropoulos C, Argentou MI, Petsas T, Thomopoulos K, Kehagias I, Kalfarentzos F. Management of gastrointestinal leaks after surgery for clinically severe obesity. Surg Obes Relat Dis. 2012;8(5):609–15.

    Article  Google Scholar 

  34. Baretta G, Campos J, Correia S, Alhinho H, Marchesini JB, Lima JH, et al. Bariatric postoperative fistula: a life-saving endoscopic procedure. Surg Endosc. 2015;29(7):1714–20.

    Article  Google Scholar 

  35. Schmidt F, Mennigen R, Vowinkel T, Neumann PA, Senninger N, Palmes D, et al. Endoscopic vacuum therapy (EVT) – a new concept for complication management in bariatric surgery. Obes Surg. 2017;27(9):2499–505.

    Article  Google Scholar 

  36. Rebibo L, Hakim S, Brazier F, Dhahri A, Cosse C, Regimbeau JM. New endoscopic technique for the treatment of large gastric fistula or gastric stenosis associated with gastric leaks after sleeve gastrectomy. Surg Obes Relat Dis. 2016;12(8):1577–84.

    Article  Google Scholar 

  37. Quezada N, Maiz C, Daroch D, Funke R, Sharp A, Boza C, et al. Effect of early use of covered self-expandable endoscopic stent on the treatment of postoperative stapler line leaks. Obes Surg. 2015;25(10):1816–21.

    Article  Google Scholar 

  38. Donatelli G, Dumont JL, Cereatti F, Dhumane P, Tuszynski T, Vergeau BM, et al. Endoscopic internal drainage as first-line treatment for fistula following gastrointestinal surgery: a case series. Endosc Int Open. 2016;4(6):E647–51.

    Article  Google Scholar 

  39. Campos JM, Ferreira FC, Teixeira AF, Lima JS, Moon RC, D’Assuncao MA, et al. Septotomy and balloon dilation to treat chronic leak after sleeve gastrectomy: technical principles. Obes Surg. 2016;26(8):1992–3.

    Article  Google Scholar 

  40. Shnell M, Gluck N, Abu-Abeid S, Santo E, Fishman S. Use of endoscopic septotomy for the treatment of late staple-line leaks after laparoscopic sleeve gastrectomy. Endoscopy. 2017;49(1):59–63.

    Google Scholar 

  41. Moon RC, Teixeira AF, Bezerra L, Alhinho H, Campos J, de Quadros LG, et al. Management of bariatric complications using endoscopic stents: a multi-center study. Obes Surg. 2018;28(12):4034–8.

    Article  Google Scholar 

  42. Galloro G, Magno L, Musella M, Manta R, Zullo A, Forestieri P. A novel dedicated endoscopic stent for staple-line leaks after laparoscopic sleeve gastrectomy: a case series. Surg Obes Relat Dis. 2014;10(4):607–11.

    Article  Google Scholar 

  43. Campos JM, Siqueira LT, Meira MR, Ferraz AA, Ferraz EM, Guimaraes MJ. Gastrobronchial fistula as a rare complication of gastroplasty for obesity: a report of two cases. J Bras Pneumol. 2007;33(4):475–9.

    Article  Google Scholar 

  44. Mahadev S, Kumbhari V, Campos JM, Galvao Neto M, Khashab MA, Chavez YH, et al. Endoscopic septotomy: an effective approach for internal drainage of sleeve gastrectomy-associated collections. Endoscopy. 2017;49(5):504–8.

    Article  Google Scholar 

  45. Zundel N, Hernandez JD, Galvao Neto M, Campos J. Strictures after laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2010;20(3):154–8.

    Article  Google Scholar 

  46. Dammaro C, Lainas P, Dumont JL, Tranchart H, Donatelli G, Dagher I. Endoscopic internal drainage coupled to prompt external drainage mobilization is an effective approach for the treatment of complicated cases of sleeve gastrectomy. Obes Surg. 2019;29(9):2929–35.

    Article  Google Scholar 

  47. Lorenzo D, Guilbaud T, Gonzalez JM, Benezech A, Dutour A, Boullu S, et al. Endoscopic treatment of fistulas after sleeve gastrectomy: a comparison of internal drainage versus closure. Gastrointest Endosc. 2018;87(2):429–37.

    Article  Google Scholar 

  48. Donatelli G, Dumont JL, Dhumane P, Dritsas S, Tuszynski T, Vergeau BM, Meduri B. Double pigtail stent insertion for healing of leaks following Roux-en-Y gastric bypass. Our experience (with videos). Obes Surg. 2017;27(2):530–5.

    Article  Google Scholar 

  49. Giuliani A, Romano L, Marchese M, Necozione S, Cianca G, Schietroma M, Carlei F. Gastric leak after laparoscopic sleeve gastrectomy: management with endoscopic double pigtail drainage. A systematic review. Surg Obes Relat Dis. 2019 Aug;15(8):1414–9.

    Article  Google Scholar 

  50. Lazzarin G, Di Furia M, Romano L, Di Sibio A, Di Giacomo C, Lombardi L, Giuliani A, Schietroma M, Pessia B, Carlei F, Marchese M. Endoscopic double-pigtail catheter (EDPC) internal drainage as first-line treatment of gastric leak: a case series during laparoscopic sleeve gastrectomy learning curve for morbid obesity. Minim Invasive Surg. 2020;2020:8250904.

    Google Scholar 

  51. Souto-Rodriguez R, Alvarez-Sanchez MV. Endoluminal solutions to bariatric surgery complications: a review with a focus on technical aspects and results. World J Gastrointest Endosc. 2017;9(3):105–26.

    Article  Google Scholar 

  52. Leeds SG, Burdick JS. Management of gastric leaks after sleeve gastrectomy with endoluminal vacuum (E-Vac) therapy. Surg Obes Relat Dis. 2016;12(7):1278–85.

    Article  Google Scholar 

  53. do Monte Junior ES, de Moura DTH, Ribeiro IB, Hathorn KE, Farias GFA, Turiani CV, Medeiros FS, Bernardo WM, de Moura EGH. Endoscopic vacuum therapy versus endoscopic stenting for upper gastrointestinal transmural defects: systematic review and meta-analysis. Dig Endosc. 2020;33(6):892–902.

    Google Scholar 

  54. de Medeiros FS, Junior ESDM, França RL, Neto HCM, Santos JM, Júnior EAA, Júnior SODS, Tavares MHSMP, de Moura EGH. Preemptive endoluminal vacuum therapy after pancreaticoduodenectomy: a case report. World J Gastrointest Endosc. 2020;12(11):493–9.

    Article  Google Scholar 

  55. Borejsza-Wysocki M, Szmyt K, Bobkiewicz A, Malinger S, Swirkowicz J, Hermann J, et al. Endoscopic vacuum-assisted closure system (E-VAC): case report and review of the literature. Wideochir Inne Tech Maloinwazyjne. 2015;10(2):299–310.

    Google Scholar 

  56. Caballero Y, Lopez-Tomassetti E, Castellot A, Hernandez JR. Endoscopic management of a gastric leak after laparoscopic sleeve gastrectomy using the over-the-scope-clip (Ovesco(R)) system. Rev Esp Enferm Dig. 2016;108:746–50.

    Article  Google Scholar 

  57. Keren D, Eyal O, Sroka G, Rainis T, Raziel A, Sakran N, et al. Over-the-scope clip (OTSC) system for sleeve gastrectomy leaks. Obes Surg. 2015;25(8):1358–63.

    Article  CAS  Google Scholar 

  58. Abd Ellatif ME, Abbas A, El Nakeeb A, Magdy A, Salama AF, Bashah MM, Dawoud I, Gamal MA, Sargsyan D. Management options for twisted gastric tube after laparoscopic sleeve gastrectomy. Obes Surg. 2017;27(9):2404–9.

    Article  Google Scholar 

  59. Dapri G, Cadiere GB, Himpens J. Laparoscopic seromyotomy for long stenosis after sleeve gastrectomy with or without duodenal switch. Obes Surg. 2009;19(4):495–9.

    Article  Google Scholar 

  60. Kolb JM, Jonas D, Funari MP, Hammad H, Menard-Katcher P, Wagh MS. Efficacy and safety of peroral endoscopic myotomy after prior sleeve gastrectomy and gastric bypass surgery. World J Gastrointest Endosc. 2020;12(12):532–41.

    Article  Google Scholar 

  61. Christou NV, Look D, Maclean LD. Weight gain after short- and long-limb gastric bypass in patients followed for longer than 10 years. Ann Surg. 2006;244(5):734–40.

    Article  Google Scholar 

  62. Brunaldi VO, Jirapinyo P, de Moura DTH, Okazaki O, Bernardo WM, Galvao Neto M, et al. Endoscopic treatment of weight regain following Roux-en-Y gastric bypass: a systematic review and meta-analysis. Obes Surg. 2018;28(1):266–76.

    Article  Google Scholar 

  63. Abu Dayyeh BK, Lautz DB, Thompson CC. Gastrojejunal stoma diameter predicts weight regain after Roux-en-Y gastric bypass. Clin Gastroenterol Hepatol. 2011;9(3):228–33.

    Article  Google Scholar 

  64. Baretta GA, Alhinho HC, Matias JE, Marchesini JB, de Lima JH, Empinotti C, et al. Argon plasma coagulation of gastrojejunal anastomosis for weight regain after gastric bypass. Obes Surg. 2015;25(1):72–9.

    Article  Google Scholar 

  65. Moon RC, Teixeira AF, Neto MG, Zundel N, Sander BQ, Ramos FM, et al. Efficacy of utilizing argon plasma coagulation for weight regain in Roux-en-Y gastric bypass patients: a multi-center study. Obes Surg. 2018;28(9):2737–44.

    Article  Google Scholar 

  66. de Quadros LG, Neto MG, Marchesini JC, Teixeira A, Grecco E, Junior RLK, et al. Endoscopic argon plasma coagulation vs. multidisciplinary evaluation in the management of weight regain after gastric bypass surgery: a randomized controlled trial with SHAM group. Obes Surg. 2020;30(5):1904–16.

    Article  Google Scholar 

  67. Brunaldi VO, Farias GFA, de Rezende DT, Cairo-Nunes G, Riccioppo D, de Moura DTH, et al. Argon plasma coagulation alone versus argon plasma coagulation plus full-thickness endoscopic suturing to treat weight regain after Roux-en-Y gastric bypass: a prospective randomized trial (with videos). Gastrointest Endosc. 2020;92(1):97–107.e5.

    Article  Google Scholar 

  68. Kumar N, Thompson CC. Transoral outlet reduction for weight regain after gastric bypass: long-term follow-up. Gastrointest Endosc. 2016;83(4):776–9.

    Article  Google Scholar 

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Acknowledgement

The authors are grateful to Patrícia Souza de Paula for their work in producing this chapter in the first edition of the book.

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Authors and Affiliations

  1. Digestive Surgery Department, Science Health Center, Pernambuco Federal University, Recife, Brazil

    Lyz Bezerra Silva & Josemberg Marins Campos

  2. Gastrointestinal Endoscopy Department, University Hospital, Unimar-Marilia University, Marília, Brazil

    Artagnan Menezes Barbosa de Amorim

  3. Advanced Institute for Metabolic Optimization, Gastro-Obeso-Center, Sao Paulo, Brazil

    Almino Cardoso Ramos

Authors
  1. Lyz Bezerra Silva
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  2. Artagnan Menezes Barbosa de Amorim
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  3. Josemberg Marins Campos
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Editors and Affiliations

  1. Homerton University Hospital, London, UK

    Sanjay Agrawal

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    Haris A. Khwaja

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Bezerra Silva, L., de Amorim, A.M.B., Campos, J.M., Ramos, A.C. (2023). Endoscopic Treatment of Complications After Bariatric Surgery. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-60596-4_53

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  • DOI: https://doi.org/10.1007/978-3-030-60596-4_53

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