Objective: To report our experience in image guided percutaneous Bioglue sealing of gastrocutaneous fistulas after bariatric surgery at Ziv Medical Center (Zefat).
Methods: A retrospective study, which included 6 patients (1 male and 5 females) who underwent percutaneous Bioglue sealing of gastrocutaneous fistulas from October 2012 to June 2017. The patients data collected from the medical files, operation logs, and the radiologic images. Selection of the patients based after confirming complication of surgery by CT images and clinical data. The first patient treated after failing of endoscopic gastric clips placement. The rest of the group treated by percutaneous drainage of the abscess and forming of gastrocutaneous fistula without any endoscopic interventions. The sealant administration performed by fluoroscopy guided fistulography and superselective delivery of Bioglue into fistula tract. Treatment results controlled by fluoroscopy with oral contrast and clinical follow up of the patients. Results of treatment compared to the data of similar studies in literature reports.
Results: 6 patients underwent percutaneous sealing with 100% success rate. 1 patient treated after failing of leak closure after endoscopic gastric clip placement. The rest of the group treated by initial percutaneous drainage of the abscess and forming of gastrocutaneous fistula without additional endoscopic interventions. All patients required continuous parenteral nutrition. Mean age of patients was 38.8 years. Majority of the patients treated by a single glue administration. One patient demanded the second procedure in two weeks.
Our results compared to the data of similar studies in literature reports and shown high success rate. No complications occurred in the follow up period.
Conclusions: Percutaneous administration of biological glue is safe and valuable alternative option of non-surgical treatment of postoperative leaks after bariatric surgery.
