AB013. OP-13 Laparoscopic approach to gastrogastric fistula and enteroenterostomy anastomosis stricture after laparoscopic gastric bypass
Abstract

AB013. OP-13 Laparoscopic approach to gastrogastric fistula and enteroenterostomy anastomosis stricture after laparoscopic gastric bypass

İsmail Ertuğrul

Department of General Surgery, SBÜ Kartal Dr. Lütfi Kirdar Education and Research Hospital, İstanbul, Turkey

Correspondence to: İsmail Ertuğrul. Department of General Surgery, SBÜ Kartal Dr. Lütfi Kirdar Education and Research Hospital, İstanbul, Turkey. Email: is_ertugrul@hotmail.com.

Abstract: The aim of this study is to present a laparoscopic revision of the patient who developed gastrogastric fistula and enteroenterostomy anastomosis stenosis after gastric bypass. A 56-year-old female patient with a body mass index (BMI) of 63.2 kg/m2 underwent laparoscopic Roux-en-Y gastric bypass. The patient was discharged without any problems except intermittent abdominal pain. Complaints were alleviated by medical treatment. Patient admitted to our clinic with the complaints of nause and vomiting in the next months. Gastroscopy was performed for suspicion of gastrojejunostomy stenosis. Gastrogastric fistula and almost completely narrowed gastrojejunostomy were observed during gastroscopy. Patient underwent laparascopic surgery on the 15th postoperative month. Narrowed gastrojejunostomy anostomosis and combined gastric pouch with gastric remnant were intraoperative findings. Biliopancreatic limb was considerably dilated. Enteroenterostomy anastomosis line was narrow. Fistulizing intestinal segment was resected. Gastric pouch and gastrojejunostomy were reconstructed. Following, enteroenterostomy was performed again distally below the previous narrowed segment. Vomiting and nausea complaints were disappeared after surgery. BMI of the patient was 38.2 kg/m2 before revision and decreased to 30 kg/m2 three months after second operation. Gastroenterostomy anastomosis narrowing should be considered in the presence of the complaints such as nausea and vomiting after Roux-en-Y gastric bypass procedures. This narrowings may lead to gastrogastric fistulas. Gastroenterostomy anastomosis stenosis, gastrogastric fistula and Enteroenterostomy anastomosis stenozis were observed in our case simultaneously. All of complications were treated successfully by using laparascopic approach.

Keywords: Enteroenterostomy anostomosis stenosis; gastric by-pass; gastrogastric fistula; gastrojejunostomy anostomosis stenosis


Footnote

Provenance and Peer Review: This abstract is included in “Abstracts from the 3rd Turkish National Congress on Bariatric and Metabolic Surgery, 21st-24th November 2019, Antalya-Turkey”, which is commissioned by the Guest Editor (Mehmet Mahir Özmen) for the series “Bariatric and Metabolic Surgery” published in Annals of Laparoscopic and Endoscopic Surgery. This abstract did not undergo external peer review.

Conflicts of Interest: The author has completed the ICMJE uniform disclosure form (available at http://dx.doi.org/10.21037/ales-2019-bms-24). The series “Bariatric and Metabolic Surgery” was commissioned by the editorial office without any funding or sponsorship. The authors have no other conflicts of interest to declare.

Ethical Statement: The author is accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

doi: 10.21037/ales-2019-bms-24
Cite this abstract as: Ertuğrul İ. OP-13 Laparoscopic approach to gastrogastric fistula and enteroenterostomy anastomosis stricture after laparoscopic gastric bypass. Ann Laparosc Endosc Surg 2020;5:AB013.