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Case Report
- A Gastrobronchial Fistula Secondary to Endoscopic Internal Drainage of a Post-Sleeve Gastrectomy Fluid Collection
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Paraskevas Gkolfakis
, Marc-André Bureau, Marianna Arvanitakis, Jacques Devière, Daniel Blero - Clin Endosc 2022;55(1):141-145. Published online April 16, 2021
- DOI: https://doi.org/10.5946/ce.2021.033
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Abstract
PDF - A 44-year-old woman underwent sleeve gastrectomy, which was complicated by a leak. She was treated with two sessions of endoscopic internal drainage using plastic double-pigtail stents. Her clinical evolution was favorable, but four months after the initial stent placement, she became symptomatic, and a gastrobronchial fistula with the proximal end of the stents invading the diaphragm was diagnosed. She was treated with antibiotics, plastic stents were removed, and a partially covered metallic esophageal stent was placed. Eleven weeks later, the esophageal stent was removed with no evidence of fistula. Inappropriate stent size, position, stenting duration, and persistence of low-grade inflammation could explain the patient’s symptoms and provide a mechanism for gradual muscle rupture and fistula formation. Although endoscopic internal drainage is usually safe and effective for the management of post-laparoscopic sleeve gastrectomy leaks, close clinical and radiological follow-up is mandatory.
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Citations
Citations to this article as recorded by
- Successful treatment of gastrobronchial fistula following laparoscopic sleeve gastrectomy: A case report and review of literature
Kai-Ho Fang, Hao-Ming Chang, Ti-Hui Wu
World Journal of Gastrointestinal Surgery.2026;[Epub] CrossRef - An Uncommon Adverse Event of Endoscopic Vacuum Therapy and Pigtail Stent Placement for the Treatment of Bariatric Surgery Leak
Luiza Bicudo de Oliveira, Mateus Pereira Funari, Ygor Rocha Fernandes, André Orsini Ardengh, Edson Ide, Igor Mendonça Proença, Tomazo Franzini, Mateus Bond Boghossian, Fauze Maluf-Filho
ACG Case Reports Journal.2026;[Epub] CrossRef - Case Report: Gastro-bronchial fistula complicating a sleeve gastrectomy: from a glimmer of hope to a plight
Adala Mourad, Adala Ahmed, Siala Rakia, Mseddi Mohamed Ali, Yaakoubi Chaima, Ben Radhia Bechir, Amara Amal, Sallemi Karim, Guizeni Rami, Ghariani Brahim, Sassi Karim, Ben Slima Mohamed
F1000Research.2025; 14: 948. CrossRef - Case Report: Gastro-bronchial fistula complicating a sleeve gastrectomy: from a glimmer of hope to a plight
Adala Mourad, Adala Ahmed, Siala Rakia, Mseddi Mohamed Ali, Yaakoubi Chaima, Ben Radhia Bechir, Amara Amal, Sallemi Karim, Guizeni Rami, Ghariani Brahim, Sassi Karim, Ben Slima Mohamed
F1000Research.2025; 14: 948. CrossRef - Management of leakage and fistulas after bariatric surgery
Stephen A. Firkins, Roberto Simons-Linares
Best Practice & Research Clinical Gastroenterology.2024; 70: 101926. CrossRef - Role of Endoscopic Internal Drainage in Treating Gastro-Bronchial and Gastro-Colic Fistula After Sleeve Gastrectomy
Alessandra D’Alessandro, Giovanni Galasso, Francesco Paolo Zito, Cristiano Giardiello, Fabrizio Cereatti, Roberto Arienzo, Filippo Pacini, Jean-Marc Chevallier, Gianfranco Donatelli
Obesity Surgery.2022; 32(2): 342. CrossRef
- Successful treatment of gastrobronchial fistula following laparoscopic sleeve gastrectomy: A case report and review of literature
- 7,096 View
- 170 Download
- 3 Web of Science
- 6 Crossref
Original Article
- Effect of Aspiration Therapy on Obesity-Related Comorbidities: Systematic Review and Meta-Analysis
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Pichamol Jirapinyo
, Diogo T. H. de Moura, Laura C. Horton, Christopher C. Thompson - Clin Endosc 2020;53(6):686-697. Published online February 28, 2020
- DOI: https://doi.org/10.5946/ce.2019.181
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Abstract
PDF
- Background
/Aims: Aspiration therapy (AT) involves endoscopic placement of a gastrostomy tube with an external device that allows patients to drain 30% of ingested calories after meals. Its efficacy for inducing weight loss has been shown. This study aimed to assess the effect of AT on obesity-related comorbidities.
Methods
A meta-analysis of studies that assessed AT outcomes was conducted through December 2018. Primary outcomes were changes in comorbidities at 1 year following AT. Secondary outcomes were the amount of weight loss at up to 4 years and pooled serious adverse events (SAEs).
Results
Five studies with 590 patients were included. At 1 year, there were improvements in metabolic conditions: mean difference (MD) in systolic blood pressure: -7.8 (-10.7 – -4.9) mm Hg; MD in diastolic blood pressure: -5.1 (-7.0 – 3.2) mm Hg; MD in triglycerides: -15.8 (-24.0 – -7.6) mg/dL; MD in high-density lipoprotein: 3.6 (0.7–6.6) mg/dL; MD in hemoglobin A1c (HbA1c): -1.3 (-1.8 – -0.8) %; MD in aspartate transaminase: -2.7 (-4.1 – -1.3) U/L; MD in alanine transaminase: -7.5 (-9.8 – -5.2) U/L. At 1 (n=218), 2 (n=125), 3 (n=46), and 4 (n=27) years, the patients experienced 17.8%, 18.3%, 19.1%, and 18.6% total weight loss (TWL), corresponding to 46.3%, 46.2%, 48.0%, and 48.7% excess weight loss (EWL) (p<0.0001 for all). Subgroup analysis of 2 randomized controlled trials (n=225) showed that AT patients lost more weight than did controls by 11.6 (6.5–16.7) %TWL and 25.6 (16.0–35.3) %EWL and experienced greater improvement in HbA1c and alanine transaminase by 1.3 (0.8–1.8) % and 9.0 (3.9–14.0) U/L. The pooled SAE rate was 4.1%.
Conclusions
Obesity-related comorbidities significantly improved at 1 year following AT. Additionally, a subgroup of patients who continued to use AT appeared to experience significant weight loss that persisted up to at least 4 years. -
Citations
Citations to this article as recorded by- Endoscopic bariatric and metabolic therapies and its effect on metabolic dysfunction-associated steatotic liver disease: a review of the current literature
Varun Aitharaju, Jonathan Ragheb, Stephen Firkins, Roma Patel, C. Roberto Simons-Linares
Surgery for Obesity and Related Diseases.2025; 21(2): 175. CrossRef - Endoscopic Weight Loss Options
Danse Bi, Pichamol Jirapinyo
Endocrinology and Metabolism Clinics of North America.2025; 54(1): 149. CrossRef - Impact of Bariatric Surgery and Endoscopic Therapies on Liver Health in Metabolic Dysfunction-Associated Steatotic Liver Disease: A Review
Dana Tasabehji, Sanaz Saleh, Mohamad Mokadem
Journal of Clinical Medicine.2025; 14(12): 4012. CrossRef - Duodenal mucosal ablation: An emerging therapeutic concept for metabolic dysfunction-associated fatty liver disease
Cornelius J Fernandez, Sweekruti Jena, Vijaya Lakshmi, Joseph M Pappachan
World Journal of Gastroenterology.2025;[Epub] CrossRef - Devices and techniques for bariatric and metabolic endoscopy: European Society of Gastrointestinal Endoscopy (ESGE) Technical and Technology Review
Ivo Boškoski, Maria Valeria Matteo, Steven Shamah, Barham K. Abu Dayyeh, Vincenzo Bove, Martina De Siena, Vincent Huberty, Roberta Maselli, Silvana Perretta, Valerio Pontecorvi, Christine Stier, Reem Z. Sharaiha, Antonio Facciorusso, Lorenzo Fuccio
Endoscopy.2025; 57(09): 1033. CrossRef - Update on Endoscopic Treatments for Obesity
Fernanda Pessorrusso, Sagar V. Mehta, Shelby Sullivan
Current Obesity Reports.2024; 13(2): 364. CrossRef - Role of endoscopic duodenojejunal bypass liner in obesity management and glycemic control
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Clinical Endoscopy.2024; 57(3): 309. CrossRef - Endobariatric systems: Strategic integration of endoscopic therapies in the management of obesity
Najib Nassani, Fateh Bazerbachi, Barham K. Abu Dayyeh
Indian Journal of Gastroenterology.2024; 43(5): 916. CrossRef - Advances in Endoscopic Bariatric and Metabolic Therapies
Reem H. Matar, Barham K. Abu Dayyeh
Gastroenterology Clinics of North America.2024; 53(4): 731. CrossRef - The evolution and current state of bariatric endoscopy in Western countries
Maria Valeria Matteo, Vincenzo Bove, Valerio Pontecorvi, Loredana Gualtieri, Giorgio Carlino, Cristiano Spada, Ivo Boškoski
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Hammad Qureshi, Naba Saeed, Manol Jovani
Journal of Clinical Medicine.2023; 12(3): 1126. CrossRef - The Role Bariatric Surgery and Endobariatric Therapies in Nonalcoholic Steatohepatitis
Aaron Yeoh, Robert Wong, Ashwani K. Singal
Clinics in Liver Disease.2023; 27(2): 413. CrossRef - Obesity management for cardiovascular disease prevention
Rama Hritani, Mahmoud Al Rifai, Anurag Mehta, Charles German
Obesity Pillars.2023; 7: 100069. CrossRef - Overview on the endoscopic treatment for obesity: A review
Maheeba Abdulla, Nafeesa Mohammed, Jehad AlQamish
World Journal of Gastroenterology.2023; 29(40): 5526. CrossRef - Endoscopic removal of a weight-loss device with stoma closure using a tack-and-suture device
Areebah Waseem, Joseph Wawrzynski, Daniel B. Maselli, Ashley Kucera, Chase Wooley, Christopher McGowan
VideoGIE.2023; 8(11): 441. CrossRef - Effect of Endoscopic Bariatric and Metabolic Therapies on Nonalcoholic Fatty Liver Disease: A Systematic Review and Meta-analysis
Pichamol Jirapinyo, Thomas R. McCarty, Russell D. Dolan, Raj Shah, Christopher C. Thompson
Clinical Gastroenterology and Hepatology.2022; 20(3): 511. CrossRef - Endobariatrics: well past infancy and maturing rapidly
Shreesh Shrestha, Esha Shrestha, Tilak Shah
Current Opinion in Gastroenterology.2022; 38(6): 592. CrossRef - Advances in endobariatrics: past, present, and future
Abhishek Shenoy, Allison R Schulman
Gastroenterology Report.2022;[Epub] CrossRef - Various Novel and Emerging Technologies in Endoscopic Bariatric and Metabolic Treatments
Hee Kyong Na, Diogo Turiani Hourneaux De Moura
Clinical Endoscopy.2021; 54(1): 25. CrossRef - Endoscopic Sleeve Gastroplasty (ESG) for High-Risk Patients, High Body Mass Index (> 50 kg/m2) Patients, and Contraindication to Abdominal Surgery
Renjie Li, Wilfried Veltzke-Schlieker, Andreas Adler, Maximilian Specht, Wael Eskander, Mahmoud Ismail, Harun Badakhshi, Manoel Passos Galvao, Ricardo Zorron
Obesity Surgery.2021; 31(8): 3400. CrossRef - Obesity Primer for the Practicing Gastroenterologist
Pichamol Jirapinyo, Christopher C. Thompson
American Journal of Gastroenterology.2021; 116(5): 918. CrossRef - Bariatric and metabolic endoscopy: impact on obesity and related comorbidities
Amit Mehta, Reem Z. Sharaiha
Therapeutic Advances in Gastrointestinal Endoscopy.2021;[Epub] CrossRef - Advanced endoscopic gastrointestinal techniques for the bariatric patient: implications for the anesthesia provider
Andrew Kim, Joshua A. Spiro, Thomas J. Hatzidais, Norman D. Randolph, Rosie Q. Li, Diana Ayubcha, Mark S. Weiss
Current Opinion in Anaesthesiology.2021; 34(4): 490. CrossRef - Preparing for the NASH Epidemic: A Call to Action
Fasiha Kanwal, Jay H. Shubrook, Zobair Younossi, Yamini Natarajan, Elisabetta Bugianesi, Mary E. Rinella, Stephen A. Harrison, Christos Mantzoros, Kim Pfotenhauer, Samuel Klein, Robert H. Eckel, Davida Kruger, Hashem El-Serag, Kenneth Cusi
Gastroenterology.2021; 161(3): 1030. CrossRef - Preparing for the NASH epidemic: A call to action
Fasiha Kanwal, Jay H. Shubrook, Zobair Younossi, Yamini Natarajan, Elisabetta Bugianesi, Mary E. Rinella, Stephen A. Harrison, Christos Mantzoros, Kim Pfotenhauer, Samuel Klein, Robert H. Eckel, Davida Kruger, Hashem El-Serag, Kenneth Cusi
Metabolism.2021; 122: 154822. CrossRef - Preparing for the NASH epidemic: A call to action
Fasiha Kanwal, Jay H. Shubrook, Zobair Younossi, Yamini Natarajan, Elisabetta Bugianesi, Mary E. Rinella, Stephen A. Harrison, Christos Mantzoros, Kim Pfotenhauer, Samuel Klein, Robert H. Eckel, Davida Kruger, Hashem El‐Serag, Kenneth Cusi
Obesity.2021; 29(9): 1401. CrossRef - Preparing for the NASH Epidemic: A Call to Action
Fasiha Kanwal, Jay H. Shubrook, Zobair Younossi, Yamini Natarajan, Elisabetta Bugianesi, Mary E. Rinella, Stephen A. Harrison, Christos Mantzoros, Kim Pfotenhauer, Samuel Klein, Robert H. Eckel, Davida Kruger, Hashem El-Serag, Kenneth Cusi
Diabetes Care.2021; 44(9): 2162. CrossRef - Endobariatrics and Metabolic Endoscopy: Can We Solve the Obesity Epidemic with Our Scope?
Jad Farha, Shahem Abbarh, Zadid Haq, Mohamad I. Itani, Andreas Oberbach, Vivek Kumbhari, Dilhana Badurdeen
Current Gastroenterology Reports.2020;[Epub] CrossRef
- Endoscopic bariatric and metabolic therapies and its effect on metabolic dysfunction-associated steatotic liver disease: a review of the current literature
- 10,447 View
- 165 Download
- 27 Web of Science
- 28 Crossref
Focused Review Series: Endoscopic Accessories Used for ESD
- Endoscopic Accessories Used for More Advanced Endoluminal Therapeutic Procedures
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Hyunsoo Chung
- Clin Endosc 2017;50(3):234-241. Published online May 31, 2017
- DOI: https://doi.org/10.5946/ce.2017.079
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Abstract
PDF
- Endoscopic accessories describe an extensive variety of auxiliary instruments used for diagnostic and therapeutic endoscopy. Various endoscopic accessories have been developed over the previous few decades and are mostly used for treating neoplastic lesions, such as early gastrointestinal (GI) carcinomas and premalignant lesions. Because of extensive research on natural orifice endoluminal surgery (NOTES) in the early 2000s and recent technological developments, new devices have been developed for various advanced endoluminal therapeutic procedures. In particular, a remarkable development of endoscopic management was achieved in the field of gastroesophageal reflux disease (GERD) and obesity. In both conditions, there is treatment gap between medical and surgical therapy. A large proportion of the patients who do not respond to medical treatment and lifestyle modification, still hesitate to directly undergo surgical treatment. To bridge this gap, endoscopic management has been receiving increasing attention. In this article, I review endoscopic and/or endoluminal devices used for the treatment of GERD and obesity with proposed mechanisms of their function.
- 11,198 View
- 153 Download
Review
- Novel Endoscopic Management of Obesity
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Jerome Dargent
- Clin Endosc 2016;49(1):30-36. Published online January 28, 2016
- DOI: https://doi.org/10.5946/ce.2016.49.1.30
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Abstract
PDF
- Endoscopic procedures have been well-documented in the obesity field, but have not yet reached a sufficient level of evidence as stand-alone methods for treating obesity. It is unclear if they should take over. Although expanding, the array of bariatric surgical techniques does not fully meet the current needs, and there are not enough resources for increasing surgery. Surgery is avoided by a majority of patients, so that less aggressive procedures are necessary. For the time being, relevant endoscopic methods include intra-gastric balloons, gastric partitioning (Endo-plication), and the metabolic field (Endo-barrier). Surgical novelties and basic research are also important contributors owing to their potential combination with endoscopy. Conditions have been listed for implementation of bariatric endoscopy, because innovation is risky, expensive, and faces ethical challenges. A scientific background is being built (e.g., hormonal studies). Some techniques require additional study, while others are not ready but should be priorities. Steps and goals include the search for conceptual similarities and the respect of an ethical frame. Minimally invasive bariatric techniques are not ready for prime time, but they are already being successful as re-do procedures. A time-frame for step-strategies can be defined, and more investments from the industry are mandatory.
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Citations
Citations to this article as recorded by- Nutritional Management and Role of Multidisciplinary Follow-Up after Endoscopic Bariatric Treatment for Obesity
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Tamer Haydara, Ahmed M. Kabel, Ayman M. Elsaka
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Nature Reviews Gastroenterology & Hepatology.2017; 14(9): 553. CrossRef
- Nutritional Management and Role of Multidisciplinary Follow-Up after Endoscopic Bariatric Treatment for Obesity
- 11,775 View
- 140 Download
- 9 Web of Science
- 13 Crossref
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