Management of sleeve gastrectomy leakage with endoscopic stenting
DOI:
https://doi.org/10.18203/2349-2902.isj20190517Keywords:
Bariatric surgery, Complication, Leakage, Obesity, Sleeve gastrectomy, StentAbstract
Background: Sleeve gastrectomy is one of the most commonly applied procedures for obesity surgery. Leakage from the stapler line and bleeding are the most important complications of sleeve gastrectomy. This study aimed to report the results of esophageal stent procedure applied to cases who developed leaks after sleeve gastrectomy.
Methods: This study included patients who had sleeve gastrectomy due to morbid obesity and were detected to have a leak after the procedure. Demographic features, time of leakage after the surgery, and the management of the leak were analyzed.
Results: it was detected in this study, 1220 cases who had sleeve gastrectomy for morbid obesity. Leaks were developed in 10 patients after Laparoscopic Sleeve Gastrectomy (LSG). Four patients, followed conservatively without stent application, were excluded. Six patients, treated with stent application, were included. Two of the patients were males, and four were females (M/F=1/2). The mean age was 38.3 (±11.57) (range: 26-58). The mean body mass index was 43.26 (±2.10)kg/m2. The incidence of a leak was 0.81%.
Conclusions: In a conclusion, stents can be safely applied by experienced endoscopists for the management of sleeve gastrectomy leakage.
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References
Kang JH, Le QA. Effectiveness of bariatric surgical procedures. A systematic review and network meta-analysis of randomized controlled trials. Med. 2017;96:46(e8632).
Bellows CF, Gauthier JM, Webber LS. Bariatric aftercare and outcomes in the Medicaid population following sleeve gastrectomy. JSLS. 2014;18(4).
Casella G, Soricelli E, Rizzello M, Trentino P, Fiocca F, Fantini A, et al. Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obesity Surg. 2009 Jul 1;19(7):821-6.
Knapps J, Ghanem M, Clements J, Merchant AM. A systematic review of staple line reinforcement in laparoscopic sleeve gastrectomy. JSLS. 2013;17:390 9.
Nguyen NT, Nguyen XM, Dholakia C. The use of endoscopic stent in management of leaks after sleeve gastrectomy. Obes Surg. 2010;20:1289-92.
Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: Review of its prevention and management. World J Gastroenterol. 2014;20:13904 10.
Durmush EK, Ermerak G, Durmush D. Short-term outcomes of sleeve gastrectomy for morbid obesity: does staple line reinforcement matter? Obes Surg. 2014;24:1109-16.
Aydin MT, Aras O, Karip B, Memisoglu K. Staple line reinforcement methods in laparoscopic sleeve gastrectomy: comparison of burst pressures and leaks. JSLS. 2015 Jul;19(3).
Cesana G, Cioffi S, Giorgi R, Villa R, Uccelli M, Ciccarese F, et al. Proximal leakage after laparoscopic sleeve gastrectomy: an analysis of preoperative and operative predictors on 1738 consecutive procedures. Obes Surg. 2018;28:627-35.
Parikh M, Issa R, McCrillis A, Saunders JK, Ude-Welcome A, Gagner M. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Annals Surg. 2013;257:231-7.
Usta S, Karabulut K. Effect of fibrin glue or suture on leakage in patients undergoing laparoscopic sleeve gastrectomy. Niger J Clin Pract. 2018;21:1209-12.
Mittermair R, Sucher R, Perathoner A. Results and complications after laparoscopic sleeve gastrectomy. Surgery today. 2014;44:1307-12.
El-Sayes IA, Frenken M, Weiner RA. Management of leakage and stenosis after sleeve gastrectomy. Surgery. 2017;162:652-61.
Sabharwal T, Morales JP, Irani FG, Adam A. Quality improvement guidelines for placement of esophageal stents. Cardiovas Interventional Radiol. 2005 Apr 1;28(3):284-8.
Dincer M, Çıtlak G, Gür HÜ, Ferlengez E, Akıncı M. Safety of Esophageal Stent Placement Without Fluoroscopy Kocaeli Med J. 2018;7:55-9.
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