Table 4.
Tissue sealants in the management of post-bariatric leak/fistula—characteristics of studies, included patients, and fistulas
| Study | Study type, n | Study information/additional treatment (n) | Sealant, n | Bariatric surgery | Age (years) | M/F | Localization of fistula (n) | Size (mm) | Symptoms |
|---|---|---|---|---|---|---|---|---|---|
| Assalia A/2018 | RS (24) | Percutaneous application under endoscopic control, first choice method of endoscopic treatment in this center | 24 | SG | 18–53, mean 42 | 10/14 | GEJ (24) | NA | Fever 83.3% pain 66.6 dyspnea 25% cloudy drainage from drain 16.6% |
| Brolin R/2013 | RS (13) | 8 leaks after laparoscopic RYGB, and 5 leaks after revision, 2 treated conservatively with TPN and drainage, 5 reoperated, 6 treated by fibrine glue from endoscopic access, 1 treated by reoperation and then fibrin glue | 7 | RYGB | 28–60 mean 46.6 | 0/13 | GE (5), pouch (2) | NA | NA |
| Papavramidis/2001 | CR (2) | Last application in patient treated with 6 sessions was done by percutaneous fistuloscopy done with choledochoscope | 2 | VBG, vertical gastroplasty with artificial pseudopylorus | 41,59 | 1/1 | Near pylorus (2) | NA |
Sepsis–1 pt Discharge from drainage tube–1 pt |
| Papavramidis S/2004 | CR (3) | TPN, somatostatin in all | 3 | Vertical gastroplasty or biliopancreatic diversion with vertical/lateral gastrectomy | 25–16 | 3/0 | Duodenojejunal junction (2) or non-defined (1) | NA | Sepsis– 3 pts |
| Papavramidis S/2008 | CR (6) | TPN, somatostatin and PPI in all. In 3 patients conservative treatment was successful | 3 | SG or biliopancreatic inversion with duodenal switch | 28,37,43 | 2/1 | Duodenojejunal anastomosis (6) | NA |
Fever- 1 pt 2 pts- NA |
| Kowalski Ch/2017 | CR (8) | Out of 8 patients, 5 was treated endoscopically, other 3 were operated because of unstable vital signs. All patients treated endoscopically had the tip of external drain found in the gastric stump | 5 | Laparoscopic RYGB | 51,42,33, 40,43 | 0/8 | Gastrojejunal anastomosis (8) | NA | NA |
| Garcia-Caballero M/2005 | CR (1) |
TPN, octreotide Tip of external drain found in the gastric lumen |
1 | One anastomosis gastric bypass | 36 | 0/1 | Gastrojejunal anastomosis (1) | NA | Routine contrast study |
| Ece I/2015 | CR (2) | TPN, drain tip in the gastric pouch | 2 | RYGB | 31,50 | 0/2 | NA | Drain size | Saliva in drain dischrge |
| Kotzampassi K/2015 | RS (63) | 63 pts with fistulas after many operation types, TPN, endscopic or mixed endoscopic and percutaneous access | 14 | NA | NA | NA | NA | NA | NA |
| Kim SY/2017 | CR (6) | Out of 6 patients 2 treated with sealants: 1st with fibrin glue and 2nd with histoacryl | 2 |
GB SG |
37,24 | 0/2 | NA | NA | Epigastric pain |
n number, CR case report, RS retrospective, SG sleeve gastrectomy, GB gastric banding, VBG vertical banded gastroplasty, RYGB Roux-en-Y gastric bypass, NA data not available