Background

Laparoscopic sleeve gastrectomy (LSG) is the most frequent bariatric operation performed worldwide. Staple-line leaks post LSG are highly challenging to treat and chronic complications such as a gastrocolic fistula are rare and require a highly skilled approach We present a case report video of laparoscopic management of a gastrocolic fistula and gastro-hepatic fistula post-LSG leak

Methods

A 34-year-old lady presented with a history of ongoing left shoulder pain post Sleeve Gastrectomy done 3 years ago. The patient was suffering from Struggling to keep weight, constant fatigue, Significant Lt side shoulder tip pain and difficulty in oral intake. A revision was done to RYGB after separation of both gastro-hepatic and gastro-colic fistulae and excision of the unhealthy part of the stomach then performing classic ante-colic Roux-en-Y gastric bypass

Results

Post-operative course was uneventful and the patient was discharged home POD 4. All preoperative symptoms resolved at 1 month follow up.

Conclusions

This is a case report of a gastrocolic fistula post sleeve gastrectomy which is a rare late postoperative complication that needs a high level of clinical suspicion and very careful surgical approach. Separation of the fistula and excision of the diseased part are considered the main pillars for the success of the operation.