Case Report on Successful Management of Gastropleural Fistula After Revisional Roux-En-Y Gastric Bypass

Revisional bariatric surgery is growing in numbers. It is indicated in patients who have weight regain and insufficient weight loss or suffer from complications from the primary bariatric surgery. Complication rates are higher for revision compared to those for primary bariatric surgery. We report a case of a patient who suffered from gastropleural fistula after revisional Roux-En-Y gastric bypass. The patient underwent open chest tube insertion and radiologically placed chest drains which failed to control the leak. Subsequently, the patient underwent video-assisted thoracic surgery and debridement of the pleural cavity. The patient's clinical condition improved after surgery and upper gastrointestinal studies 3 weeks after surgery showed the leak had sealed off. Gastropleural fistula is an uncommon complication after revision bariatric surgery. Principles of management include early recognition, aggressive sepsis management, and multi-modal therapy.