Sahil Gambhir, MD, James Nguyen, MD, Shaun Daly, MD, Brian R Smith, MD, Ninh T Nguyen, Marcelo W Hinojosa, MD. University of California Irvine Medical Center
INTRODUCTION: Although a gastrogastric fistula formation after a Roux-en-Y gastric bypass (RYGB) remains infrequent, the complications including weight gain remain prominent.
METHODS: This is 60 year old male with a medical history of hypertension, obstructive sleep apnea, a previous RYGB and subsequent abdominoplasty, laparoscopic ventral hernia repair with mesh. After an initial 200 IB weight loss, he reported weight gain of greater than 60 IBs. A CT of A/P were obtained which revealed a large gastric pouch. An upper gastrointestinal study (UGIS) revealed an abnormal communication btw the gastric pouch into the remnant which was initially excluded. This was followed by an esophagogastroduodenoscopy which confirmed the large fistula. He was noted to be an appropriate surgical candidate and we proceeded with a laparoscopic gastrojejunostomy revision and takedown of gastrogastric fistula.
RESULTS: The operation was completed as planned without intraoperative complications. Operative time took 4.5 hours. Blood loss was minimal. On postoperative day 1, he had an UGIS which was negative for leak and subsequently started on bariatric clears. He was discharged after postoperative day 3. He was seen in clinic several weeks later and reported a 46 IB weight loss.
CONCLUSION: We demonstrate a laparoscopic repair of a gastrogastric fistulas after open RYGB is feasible.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 95231
Program Number: V157
Presentation Session: Video Loop Day 1
Presentation Type: VideoLoop
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