5 years ago

Management of Gastropleural Fistula after Revisional Bariatric Surgery: A Hybrid Laparoendoscopic Approach

Omar M. Ghanem, Todd A. Kellogg, Barham K. Abu Dayyeh



Gastropleural fistula (GPF) is a serious complication after bariatric surgery. Multiple treatment modalities including pharmacologic, endoscopic, and revisional surgery have been proposed. We present a case of a GPF managed successfully with a laparoendoscopic approach utilizing a fistula plug.


A 43-year-old male patient presented with a GPF after a revisional bariatric surgery. A laparoendoscopic approach including lysis of adhesions, identification of the fistula, plugging the fistula with a BioGore A® fistula plug, placement an enteric stent, placement of a feeding tube, and surgical drainage was performed. The multimedia video illustrates the technique used.


Postoperatively, upper gastrointestinal (UGI) imaging showed no evidence of leak. The enteric stent was removed after 2 months after verifying complete healing of the fistula.


A laparoendoscopic approach to GPF repair with the use of fistula plug is effective, safe, and feasible.

Publisher URL: https://link.springer.com/article/10.1007/s11695-017-2836-x

DOI: 10.1007/s11695-017-2836-x

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