Roux-En-Y Fistulojejunostomy for Post-Sleeve Gastrectomy Fistula

Elie K Chouillard, MD, PhD, Jean Biagini, MD, FACS, Nelson Trelles, MD, Mohammad Al Jarallah, MD


Introduction: Fistula is still a concern after Sleeve Gastrectomy (SG) in patients with morbid obesity. Although the risk of fistula is relatively low (< 5 %), its treatment is long, non standardized, and complex. Surgery may be indicated in selected cases. In this study, we present ou experience with Roux-en-Y fistulo-jejunostomy (RYFJ) in selected patients with fistula after SG.

Methods and procedures: Between January 2005 and December 2011, we treated 51 patients with post SG fistula. Sixteen of these had RYFJ.

Results: 8 patients were operated laparoscopically and 8 had open surgery. No major operative incident was encountered. Mortality was 0 %. No patient was transfused. Operative duration was 160 minutes (120-330 minutes). The healing rate of the fistula was 100 %.

The mean postoperative follow-up was 39 months (13-66). The fistulojejujonstomy remained patent in all but one patient upon endoscopy. Ten patients had chronic diarrhea (62,5 %). Sixpatients (37,5 %) suffered from chronic pancreatic insufficiency. All patients needed vitamine and oligoelements medication. Adequate weight loss and comorbidity remission was achieved in all patients.

Conclusions: RYFJ for post SG fistula is a feasible and sure option. The metabolic outcome of this procedure is ill-known.

Session: Podium Presentation

Program Number: S084

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