Closure of Gastrocutaneous Fistula Following Bariatric Surgery: a Systematic Review

Obes Surg. 2023 Nov;33(11):3658-3668. doi: 10.1007/s11695-023-06861-3. Epub 2023 Oct 7.

Abstract

Gastrocutaneous fistula (GCF) is a devastating complication that can arise after bariatric and metabolic surgery (BMS). This systematic review examines the success rate of closure techniques of GCF. A systematic search was conducted across MEDLINE, Embase and Cochrane databases to identify studies which reported on closure techniques of GCF after BMS in adults. Thirty-three studies (n = 108 patients) were included. Seventeen different techniques were used to close GCF across all studies. The most popular were stents (n = 17), tissue sealants (n = 12) and over-the-scope clips (n = 11). Twenty-one studies used multiple techniques to attempt closure, including endoscopic vacuum therapy and revisional surgery. This systematic review demonstrates current practice focusing on endoscopic methods such as stents and over-the-scope clips, with relative success in closing GCF.

Keywords: Bariatric surgery; Closure technique; Gastrocutaneous fistula.

Publication types

  • Systematic Review
  • Review

MeSH terms

  • Adult
  • Bariatric Surgery* / adverse effects
  • Cutaneous Fistula* / complications
  • Cutaneous Fistula* / surgery
  • Gastric Fistula* / etiology
  • Gastric Fistula* / surgery
  • Gastrostomy / adverse effects
  • Humans
  • Obesity, Morbid* / surgery