ENDOSCOPIC PROSTHESIS FOR TREATMENT OF GASTRIC FISTULA IN THE POST-OPERATIVE BARIATRIC OPERATION

Abstract

OBJECTIVES: To systematically review the literature on the use of endoscopic prosthesis for the treatment of gastric fistula in the postoperative period of bariatric surgeries, evaluating the presence of complications, in addition to the type of surgical approach and stents used. METHODOLOGY: Integrative bibliographic review, following the PRISMA protocol. The searches were carried out in the online databases: PubMed, Virtual Health Library (VHL) of the Ministry of Health, and Cochrane Library, with an interval of 10 years (2023-2013). RESULTS/DISCUSSION: 17 studies were evaluated, containing a total of 1170 patients. 70% performed Sleeve; 25.81% Roux-Y Bypass; 2.39% performed other approaches and 1.79% did not inform. It was found that the most used was the SEMS (Self-expandable Metallic Stent). The most common complication was migration, perforation and intolerance. Obesity surgery is justified because it produces sustained weight loss, increases life expectancy and reduces the complications of obesity. It was found that RYGB, SG and laparoscopic adjustable gastric banding (LAGB) are considered the first-line treatment option in patients with severe obesity. However, postoperative complications increase and appropriate management of these complications has become important. More serious complications, such as leaks and fistulas, can be treated with endoscopic stent placement. CONCLUSION: It was demonstrated that the endoscopic approach is an option for treating complications, avoiding surgical interventions and achieving high effectiveness, with SEMS being the most used, with no relationship between the type of procedure and the need for a stent.