Drain Amylase Levels in the Early Diagnosis of Gastric Leak after Laparoscopic Sleeve Gastrectomy

Romano, Lucia; Giuliani, Antonio; Furia, M.; Meloni, Danilo; Cianca, Giovanni; Mattei, Antonella Souza; Fiasca, Fabiana; Tonelli, Emilio; Carlei, F; Schietroma, M

doi:10.1159/000517949

Cited by 3 publications

(2 citation statements)

References 28 publications

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“…High drain fluid amylase level rates might be seen in all leaks in the gastrointestinal system, especially in pancreatic fistula (15). However, in another study; the determination of drain fluid amylase levels after sleeve gastrectomy was shown as a significant indicator of gastric leak with high sensitivity and specificity (16).…”

Section: Discussionmentioning

confidence: 94%

Can the Drain Ph Be Used to Predict Risk of Leakage in Patients With Sleeve Gastrectomy?

2022

ircmj

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Aim: Laparoscopic Sleeve Gastrectomy is the most common type of surgical treatment for morbid obesity. One of the most important complications is leakage from the stapler line. Early detection of a leakage is important in preventing undesirable events. The aim of this study was to evaluate the predictive value of postoperative drain fluid pH on early detection of leakage. Materials and Methods: This study was performed with 63 patients including 33 patients who underwent laparoscopic sleeve gastrectomy for morbid obesity (Group SG) and 30 patients who underwent laparoscopic cholecystectomy (Group LC), as the control group. Fluid sample was obtained after surgery with intraabdominal drain. The pH value of this fluid was measured using a pH Meter at the Ohaus device in the biochemistry laboratory of this hospital. Findings: When the differences in the mean pH values of patients who underwent Obesity surgery and Gallbladder surgery were evaluated; no statistically significant difference was found between the mean PH value of patients (p: 0.808> 0.05). Conclusion: None of our patient had leakage and unable to demonstrate how would be the drain fluid pH value if there was a leak, we suggest that drain fluid pH would not alert for a leakage in the early period. Because we know that most of the leaks occur at the proximal part of the stomach and we know that there is more saliva drainage through the line of leakage. Although it is known that the acidic fluid of the stomach can be drained from the same leak in this condition, it is not unlikely that saliva can bring the pH to normal levels. Therefore, one should not forget that if the pH of the drain fluid is close to normal, it is impossible to state that there is no leakage.

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Section: Discussionmentioning

confidence: 94%

Can the Drain Ph Be Used to Predict Risk of Leakage in Patients With Sleeve Gastrectomy?

2022

ircmj

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“…a) Extravasation of contrast dye or GIT discharges through the intraperitoneal drain (The drain amylase levels after LSG is a significant predictive factor of GSLL with high specificity and sensitivity) (16) . b) Confirmatory laboratory and clinical evidence of sepsis.…”

Section: Definition and Classification Of Gsllmentioning

confidence: 99%

Gastric Staple Line Leaks After Laparoscopic Sleeve Gastrectomy, Endoscopic Stent Insertion Versus Surgical Intervention Treatment

Baz¹,

Mohamed²,

Ezzat³

2023

The Egyptian Journal of Hospital Medicine

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Background: Endoscopic stenting (ES) provides comfortable management of Gastric staple line leaks (GSLL); it is less invasive than conventional surgery. Objective: The aim of the current study is to assess the efficacy of endoscopic stenting versus surgical intervention in treating gastric stable line leakage following laparoscopic sleeve gastrectomy (LSG). Patients and methods: In Helwan University Hospitals, 40 patients had GSLL post LSG between January 2018 and August 2022. We proceeded our management to either: ES placement (Group A) or surgical management (SM) (Group B), 2o in each group. Results: Regarding postoperative complications, there is a significant statistical difference regarding wound infection, but no significant difference regarding chest infection, DVT, subphrenic abscess, severe vomiting, GERD, failure of Roux-en-Y, stent migration, or stricture. There is a non-significant association between the type of participant management and the outcomes of the intervention. However, there was a statistically significant association between the type of participant management and the interval period between GSLL closure and its control (P value <0.001) and patients' hospital stay (P= 0.001), as participants who underwent ES spent less time in the hospital. Conclusion: Management of post-LSG leakage with ES is advocated as it is a minimally invasive technique that effectively manages GSLL and has a comparable control success rate to definitive surgical treatment with a shorter hospital stay, early return of function, fewer complications, and a well-tolerable safety profile. In stable patients, ES should be recommended as first-line therapy.

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Comment on: Outcomes of same-day discharge sleeve gastrectomy and Roux-en-Y gastric bypass: a systematic review and meta-analysis

Dan

2023

Surgery for Obesity and Related Diseases

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Drain Amylase Levels in the Early Diagnosis of Gastric Leak after Laparoscopic Sleeve Gastrectomy

Cited by 3 publications

References 28 publications

Can the Drain Ph Be Used to Predict Risk of Leakage in Patients With Sleeve Gastrectomy?

Can the Drain Ph Be Used to Predict Risk of Leakage in Patients With Sleeve Gastrectomy?

Gastric Staple Line Leaks After Laparoscopic Sleeve Gastrectomy, Endoscopic Stent Insertion Versus Surgical Intervention Treatment

Comment on: Outcomes of same-day discharge sleeve gastrectomy and Roux-en-Y gastric bypass: a systematic review and meta-analysis

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