Treatment of leaks and fistulae after bariatric surgery

Gastric leaks are an ominous complication following Roux-en-Y gastric bypass associated with a high mortality. Surgical revision is often complicated and not without risk. Several series have brought to light endoscopic interventions that may play a role in the management of these patients. This paper provides an overview of the surgical approach to this difficult problem and outlines several endoscopic approaches to gastric leak and fistulae management, including stents, clips, fibrin glue, and endoscopic suturing.