{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T05:59:56Z","timestamp":1769061596745,"version":"3.49.0"},"reference-count":15,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,11,15]],"date-time":"2017-11-15T00:00:00Z","timestamp":1510704000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2017,11,15]],"date-time":"2017-11-15T00:00:00Z","timestamp":1510704000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Laparoscopic sleeve gastrectomy is a common surgical management of morbid obesity. Major complication rate is 3\u20138%. Staple line leak is one of the most serious complications. In a small group of patients, a gastro\u2010pulmonary fistula is formed. Endoscopic and minimally invasive measures are the first line of treatment with considerable success rate. There are very poor data in the literature what should be done in cases of failure. In this paper, we report our positive experience with definitive surgical repair.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective evaluation of 13 consecutive patients referred to the general thoracic surgery department for gastro\u2010pulmonary fistula following sleeve gastrectomy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Prior to their referral, all patients underwent surgical or percutaneous drainage and multiple treatment attempts including stent insertion, pyloric dilatation, endo\u2010clip\/ring closure, endoscopic argon ablation and glue injection. Two patients underwent emergency thoracotomy for sepsis and bile empyema. One died in the early postoperative period. Eleven patients underwent semi\u2010elective definitive surgery. Surgery included left lower lobectomy, partial diaphragmectomy and digestive system reconstruction. There was no mortality or major complications in this group. Complication rate was 45% mostly local wound infection and pneumonia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Gastro\u2010pulmonary fistula is a rare devastating complication of sleeve gastrectomy. When minimally invasive measures fail, there is no place for nihilism. Surgical repair is possible and safe. The data presented herein support this treatment policy.<\/jats:p><\/jats:sec>","DOI":"10.1007\/s00268-017-4358-z","type":"journal-article","created":{"date-parts":[[2017,11,15]],"date-time":"2017-11-15T16:01:28Z","timestamp":1510761688000},"page":"1792-1797","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Surgical Treatment of Gastro\u2010Pulmonary Fistula Following Bariatric Surgery: Possible and Safe"],"prefix":"10.1002","volume":"42","author":[{"given":"Alon","family":"Ben Nun","sequence":"first","affiliation":[{"name":"Department of General Thoracic Surgery, Sheba Medical Center, and Sackler School of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"David","family":"Simansky","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Sheba Medical Center, and Sackler School of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Merav","family":"Rokah","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Sheba Medical Center, and Sackler School of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nona","family":"Zeitlin","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Sheba Medical Center, and Sackler School of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nir","family":"Golan","sequence":"additional","affiliation":[{"name":"Department of General Thoracic Surgery, Sheba Medical Center, and Sackler School of Medicine Tel\u2010Aviv University Tel Aviv Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramez","family":"Abu Khalil","sequence":"additional","affiliation":[{"name":"Department of 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