Aimal Khan, MD, Jason Howard, MD, Alfred Trang, MD, Renee Tholey, MD, Ramsey M Dallal, MD. Einstein Healthcare Network
INTRODUCTION: Endoscopic stents have been used to treat bariatric surgery complications; however, data is lacking in the indications and efficacy.
METHODS: A single institutional retrospective observational trial spanning 10 years of all bariatric surgery complications managed with endoscopic stents.
RESULTS: 15 patients underwent 21 fully covered stent placement procedures. Indications for stent placement were leak in 8 patients (1 sleeve; 7 bypass) and stricture in 7 patients (4 bypass, 3 sleeve). Five patients had stent migration. Three required surgical removal, one patient endoscopic repositioning and one passed the stent per rectum. All eight patients with enteric leak successfully underwent stent placement in conjunction with diagnostic laparoscopy and drainage. All but one of these patients developed an enteric leak perioperative to index procedure. The average duration of stent treatment in these patients was 21 days (14-47 days). Of the 7 patients treated for a stricture, 3 patients (2 sleeve, 1 bypass) failed treatment and required subsequent definitive operative revision. Average length of time of stent treatment in these patients was 3 days (range, 1-14 days) and five had severe intolerance.
CONCLUSIONS: Endoscopic stent placement of leak may require multiple procedures and carries the risk of migration; however, this therapy seems to be an effective treatment. Failure rates are higher with strictures and are not as tolerated by patients.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87467
Program Number: P384
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster