Fang KH, Chang HM, Wu TH. Successful treatment of gastrobronchial fistula following laparoscopic sleeve gastrectomy: A case report and review of literature. World J Gastrointest Surg 2026; 18(1): 114041 [DOI: 10.4240/wjgs.v18.i1.114041]
Corresponding Author of This Article
Ti-Hui Wu, MD, PhD, Assistant Professor, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University, No. 325, Section 2, Chenggong Road, Nei Hu, Taipei 114, Taiwan. cstsgh1978@gmail.com
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Gastroenterology & Hepatology
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Case Report
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This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Jan 27, 2026 (publication date) through Jan 28, 2026
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World Journal of Gastrointestinal Surgery
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1948-9366
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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA
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Fang KH, Chang HM, Wu TH. Successful treatment of gastrobronchial fistula following laparoscopic sleeve gastrectomy: A case report and review of literature. World J Gastrointest Surg 2026; 18(1): 114041 [DOI: 10.4240/wjgs.v18.i1.114041]
World J Gastrointest Surg. Jan 27, 2026; 18(1): 114041 Published online Jan 27, 2026. doi: 10.4240/wjgs.v18.i1.114041
Successful treatment of gastrobronchial fistula following laparoscopic sleeve gastrectomy: A case report and review of literature
Kai-Ho Fang, Hao-Ming Chang, Ti-Hui Wu
Kai-Ho Fang, Hao-Ming Chang, Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei 114, Taiwan
Ti-Hui Wu, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University, Taipei 114, Taiwan
Author contributions: Fang KH drafted, edited, and reviewed the manuscript; Chang HM contributed to editing and reviewing; Wu TH reviewed and supervised the work; and all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Ti-Hui Wu, MD, PhD, Assistant Professor, Division of Thoracic Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical University, No. 325, Section 2, Chenggong Road, Nei Hu, Taipei 114, Taiwan. cstsgh1978@gmail.com
Received: September 10, 2025 Revised: October 23, 2025 Accepted: December 2, 2025 Published online: January 27, 2026 Processing time: 133 Days and 16.6 Hours
Abstract
BACKGROUND
Gastrobronchial fistula (GBF) is a rare but severe complication after sleeve gastrectomy (SG). GBF is associated with significant morbidity and mortality. Diagnosis is often delayed due to nonspecific symptoms. Therefore, timely recognition and management are critical. Endoscopic management, as the cornerstone of initial therapy, can be performed in a combined or stepwise manner for chronic or refractory cases.
CASE SUMMARY
A 48-year-old male with class II obesity and metabolic syndrome underwent laparoscopic SG. Six months later, he developed poor oral intake, chest pain, and dyspnea. Chest radiography and computed tomography revealed massive left pleural effusion, and laboratory tests showed leukocytosis. Video-assisted thoracoscopic surgery and esophagogastroduodenoscopy revealed a fistulous tract between the sleeved stomach and pleural cavity. Management included decortication, nasoduodenal feeding, and multiple sessions of endoscopic vacuum therapy. Although the fistula orifice decreased in size, an upper gastrointestinal series performed during follow-up indicated progression to GBF. We repeated decortication and placed a covered self-expandable metallic stent. Six weeks later, the stent was removed. Esophagogastroduodenoscopy confirmed that the GBF successfully healed.
CONCLUSION
Early suspicion, prompt diagnosis, and adequate intervention of GBF are crucial when the complication arises after laparoscopic SG. Endoscopic approaches, such as endoscopic vacuum therapy and stenting, are effective first-line therapies.
Core Tip: Treatment for gastropleural fistula/gastrobronchial fistula ranges from minimally invasive endoscopic procedures to major surgical interventions. Endoscopic therapy, such as endoscopic vacuum therapy and self-expandable metallic stent placement, is an increasingly favored initial treatment of gastrobronchial fistula due to its safety and efficacy. In complex or refractory cases a combined or stepwise approach can achieve successful closure while avoiding the morbidity of extensive surgery.
