Pylorus-preserving laparoscopic proximal gastric resection with Roux-en-Y esophagojejunostomy for late gastrocolic fistula after sleeve gastrectomy
Abstract
Laparoscopic sleeve gastrectomy (LSG) is among the most common metabolic bariatric procedures, but staple-line leak occurs in 1%–3% of cases and may evolve into chronic fistula. Gastrocolic fistula is rare and lacks standardized treatment. We describe a 44-year-old woman (body mass index 43 kg/m2) who developed a late staple-line leak 7 months after LSG that progressed to a gastrocolic fistula, with mega-stent-related pressure necrosis of the transverse colon as the proximate mechanism. After failed conservative and endoscopic management, laparoscopic revision was performed: adhesiolysis, proximal gastric resection, primary repair of the 4-cm colonic defect with omental patch, and Roux-en-Y esophagojejunostomy with anterior cruroplasty. The patient was discharged on postoperative day 15 and remained asymptomatic through 12 months, with intact anastomoses and no recurrence. Unlike previously reported proximal, near-total, or total gastrectomies, the distal antrum and pylorus were preserved. Laparoscopic revision is feasible and effective for this complex complication after LSG.
Related
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BibTeX
@article{teshaev2026pyloruspreserving,
title = {{Pylorus-preserving laparoscopic proximal gastric resection with Roux-en-Y esophagojejunostomy for late gastrocolic fistula after sleeve gastrectomy}},
author = {Oktyabr Teshaev and Nozim Jumaev and Ziyoda Muminova and Irina Lim and Jafar Zafarovich Juraev and Azam Bobabekov},
journal = {Journal of Surgical Case Reports},
year = {2026},
month = oct,
doi = {10.1093/jscr/rjag928},
url = {https://doi.org/10.1093/jscr/rjag928},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Pylorus-preserving laparoscopic proximal gastric resection with Roux-en-Y esophagojejunostomy for late gastrocolic fistula after sleeve gastrectomy
AU - Oktyabr Teshaev
AU - Nozim Jumaev
AU - Ziyoda Muminova
AU - Irina Lim
AU - Jafar Zafarovich Juraev
AU - Azam Bobabekov
PY - 2026
DA - 2026/10/22
JO - Journal of Surgical Case Reports
DO - 10.1093/jscr/rjag928
UR - https://doi.org/10.1093/jscr/rjag928
AB - Laparoscopic sleeve gastrectomy (LSG) is among the most common metabolic bariatric procedures, but staple-line leak occurs in 1%–3% of cases and may evolve into chronic fistula. Gastrocolic fistula is rare and lacks standardized treatment. We describe a 44-year-old woman (body mass index 43 kg/m2) who developed a late staple-line leak 7 months after LSG that progressed to a gastrocolic fistula, with mega-stent-related pressure necrosis of the transverse colon as the proximate mechanism. After failed conservative and endoscopic management, laparoscopic revision was performed: adhesiolysis, proximal gastric resection, primary repair of the 4-cm colonic defect with omental patch, and Roux-en-Y esophagojejunostomy with anterior cruroplasty. The patient was discharged on postoperative day 15 and remained asymptomatic through 12 months, with intact anastomoses and no recurrence. Unlike previously reported proximal, near-total, or total gastrectomies, the distal antrum and pylorus were preserved. Laparoscopic revision is feasible and effective for this complex complication after LSG.
SN - 2042-8812
ER -