Traitement d'une fistule chronique post-sleeve gastrectomie par une anse en Y

Sleeve gastrectomy, a new restrictive bariatric procedure, is being performed with increasing frequency for the treatment of morbid obesity. The most serious complication after this procedure is gastric fistula. If the fistula cannot be corrected with re-operative closure, conservative management of chronic gastric fistula includes external drainage, endoprosthesis, and fibrin glue tract obliteration. If these lesser approaches fail to control the fistula, total gastrectomy has been proposed as a radical surgical approach; this procedure is usually technically difficult and has significant functional consequences. Internal drainage of chronic gastric fistula by a Roux-en-Y gastrojejunostomy has been proposed as an alternative to radical gastric resection. We report the case of a patient successfully managed in this way.