scholarly journals Endoscopic Internal Drainage with Double Pigtail Stents for Upper Gastrointestinal Anastomotic Leaks: Suitable for All Cases?

2022 ◽  
Author(s):  
Bin Chet Toh ◽  
Jingli Chong ◽  
Baldwin PM Yeung ◽  
Chin Hong Lim ◽  
Eugene KW Lim ◽  
...  
Keyword(s):  
Anastomotic Leaks ◽  
Internal Drainage ◽  
Endoscopic Internal Drainage ◽  
Upper Gastrointestinal

scholarly journals International multicenter expert survey on endoscopic treatment of upper gastrointestinal anastomotic leaks

2019 ◽  
Vol 07 (12) ◽  
pp. E1671-E1682 ◽  
Author(s):  
Eduardo Rodrigues-Pinto ◽  
Alessandro Repici ◽  
Gianfranco Donatelli ◽  
Guilherme Macedo ◽  
Jacques Devière ◽  
...  
Keyword(s):  
Balloon Dilation ◽  
Metal Stents ◽  
Vacuum Therapy ◽  
Anastomotic Leaks ◽  
Oncologic Surgery ◽  
Endoscopic Techniques ◽  
Persistent Inflammation ◽  
Small Leak ◽  
Endoscopic Internal Drainage ◽  
Upper Gastrointestinal

Abstract Background and study aims A variety of endoscopic techniques are currently available for treatment of upper gastrointestinal (UGI) anastomotic leaks; however, no definite consensus exists on the most appropriate therapeutic approach. Our aim was to explore current management of UGI anastomotic leaks. Methods A survey questionnaire was distributed among international expert therapeutic endoscopists regarding management of UGI anastomotic leaks. Results A total of 44 % of 163 surveys were returned; 69 % were from gastroenterologists and 56 % had > 10 years of experience. A third of respondents treat between 10 and 19 patients annually. Fifty-six percent use fully-covered self-expandable metal stents as their usual first option; 80% use techniques to minimize migration; 4 weeks was the most common reported stent dwell time. Sixty percent perform epithelial ablation prior to over-the-scope-clip placement or suturing. Regarding endoscopic vacuum therapy (EVT), 56 % perform balloon dilation and intracavitary EVT in patients with large cavities but small leak defects. Regarding endoscopic septotomy, 56 % consider a minimal interval of 4 weeks from surgery and 90 % consider the need to perform further sessions. Regarding endoscopic internal drainage (EID), placement of two stents and shorter stents is preferred. Persistent inflammation with clinical sepsis was the definition most commonly reported for endoscopic failure. EVT/stent placement and EVT/EID were the therapeutic options most often chosen in patients with previous oncologic surgery and previous bariatric surgery, respectively. Conclusions There is a wide variation in the management of patients with UGI anastomotic leaks. Future prospective studies are needed to move from an expert- to evidence- and personalization-based care.

scholarly journals Endoscopic internal drainage using transmural double-pigtail stents in leaks following upper gastrointestinal tract surgery.

2020 ◽  
Author(s):  
Esteban Fuentes-Valenzuela ◽  
Francisco Javier García-Alonso ◽  
Javier Tejedor-Tejada ◽  
Rodrigo Najera-Muñoz ◽  
Marina De Benito Sanz ◽  
...  
Keyword(s):  
Gastrointestinal Tract ◽  
Upper Gastrointestinal Tract ◽  
Internal Drainage ◽  
Endoscopic Internal Drainage ◽  
Upper Gastrointestinal

Endoscopic Internal Drainage and Low Negative Pressure Endoscopic Vacuum Therapy for anastomotic leaks after oncologic upper gastrointestinal surgery

Endoscopy ◽  
2021 ◽  
Author(s):  
Carlo Jung ◽  
Rachel Hallit ◽  
Annegret Müller-Dornieden ◽  
Melanie Calmels ◽  
Diane Goere ◽  
...  
Keyword(s):  
Negative Pressure ◽  
Treatment Duration ◽  
Treatment Success ◽  
Univariate Analysis ◽  
Gastrointestinal Surgery ◽  
Vacuum Therapy ◽  
Internal Drainage ◽  
Upper Gi ◽  
Endoscopic Internal Drainage ◽  
Endoscopic Vacuum Therapy

Background: Endoscopic internal drainage (EID) with double pigtail stents and low negative pressure endoscopic vacuum therapy (EVT) are treatment options for leakages after upper GI oncologic surgery. We aimed to compare the effectiveness of these techniques. Patients and methods: Between 2016 and 2019, patients treated with EID in five centers in France and with EVT in Göttingen, Germany were included and retrospectively analyzed using univariate analysis. Pigtails were changed every 4 weeks, EVT was repeated every 3-4 days until leak closure. Results: 35 EID and 27 EVT patients were included, with a median leak size of 0.75 cm (0.5-1.5). Overall treatment success was 100% [CI 90; 100] in EID vs. 85.2% [CI 66.3; 95.8] in EVT, p=0.03. The median number of endoscopic procedures was 2 (2; 3) vs. 3 (2; 6.5), p<0.01 and the median treatment duration was 42 (28; 60) vs. 17 days (7.5; 28), p<0.01, for EID vs. EVT, respectively. Conclusion: EID and EVT provide high closure rates for upper GI anastomotic leakages. EVT provides a shorter treatment duration at the cost of a higher number of procedures.

Self-expanding Metal Stents for Anastomotic Leaks After Upper Gastrointestinal Cancer Surgery

2021 ◽  
Vol 267 ◽  
pp. 516-526
Author(s):  
Lukas F. Liesenfeld ◽  
Thomas Schmidt ◽  
Christine Zhang-Hagenlocher ◽  
Peter Sauer ◽  
Markus K. Diener ◽  
...  
Keyword(s):  
Gastrointestinal Cancer ◽  
Cancer Surgery ◽  
Metal Stents ◽  
Anastomotic Leaks ◽  
Upper Gastrointestinal Cancer ◽  
Self Expanding Metal Stents ◽  
Upper Gastrointestinal

Endoscopic internal drainage of complex bilomas/biliary leaks by transmural or transpapillary-transfistulary access

2021 ◽  
Author(s):  
Diane Lorenzo ◽  
Laura Bromberg ◽  
Marianna Arvanitakis ◽  
Myriam Delhaye ◽  
Michael Fernandez Y. Viesca ◽  
...  
Keyword(s):  
Internal Drainage ◽  
Endoscopic Internal Drainage

Role of Endoscopic Internal Drainage in Treating Gastro-Bronchial and Gastro-Colic Fistula After Sleeve Gastrectomy

2021 ◽  
Author(s):  
Alessandra D’Alessandro ◽  
Giovanni Galasso ◽  
Francesco Paolo Zito ◽  
Cristiano Giardiello ◽  
Fabrizio Cereatti ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Internal Drainage ◽  
Endoscopic Internal Drainage
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