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Proximal Gastrectomy with Double Tract Reconstruction Is an Alternative Revision Surgery for Intractable Complications After Sleeve Gastrectomy

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Abstract

Gastric leakage and stricture are challenging complications of sleeve gastrectomy (SG). Failure of endoscopic intervention necessitates revision surgery. We describe two cases in which proximal gastrectomy with double tract reconstruction (PG with DTR) was performed in patients with chronic gastric fistula and twisted gastric tube after SG. Following resection of the affected part of the proximal stomach, reconstruction was achieved with three anastomoses [esophagojejunostomy (EJ), gastrojejunostomy (GJ), and jejunojejunostomy]. DTR provides two exit routes, the remnant stomach and the distal jejunum. The GJ was created 15 cm below the EJ with a stoma 10 mm in diameter, which can pass a standard endoscope. Both cases were a success without any short-term complications. PG with DTR could be an alternative option for refractory complications of SG.

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Authors and Affiliations

  1. Department of Surgery, Toho University Sakura Medical Center, 564-1 Shimoshizu, Sakura, Chiba, 285-8741, Japan

    Takashi Oshiro, Yu Sato, Taiki Nabekura, Tomoaki Kitahara, Ayami Sato, Kengo Kadoya, Kentarou Kawamitsu, Ryuichi Takagi, Makoto Nagashima, Shinichi Okazumi & Ryoji Katoh

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  1. Takashi Oshiro
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  2. Yu Sato
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  3. Taiki Nabekura
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  4. Tomoaki Kitahara
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  5. Ayami Sato
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  6. Kengo Kadoya
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  7. Kentarou Kawamitsu
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  8. Ryuichi Takagi
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  9. Makoto Nagashima
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  10. Shinichi Okazumi
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  11. Ryoji Katoh
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Corresponding author

Correspondence to Takashi Oshiro.

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The authors declare that they have no conflicts of interest.

Ethical Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants in this study.

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Oshiro, T., Sato, Y., Nabekura, T. et al. Proximal Gastrectomy with Double Tract Reconstruction Is an Alternative Revision Surgery for Intractable Complications After Sleeve Gastrectomy. OBES SURG 27, 3333–3336 (2017). https://doi.org/10.1007/s11695-017-2935-8

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  • DOI: https://doi.org/10.1007/s11695-017-2935-8

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