Experience in laparoscopic sleeve gastrectomy for morbidly obese Taiwanese: staple-line reinforcement is important for preventing leakage

Abstract

LSG is an effective obesity treatment to achieve significant weight loss after 24 months. Staple-line reinforcement is strongly recommended for laparoscopic sleeve gastrectomy to decrease complications.

Intra-abdominal infectious complications following gastrectomy in patients with excessive visceral fat

“…To date, the risk factors for anastomotic leakage after gastrectomy have not been completely clarified [26]. Both Ser et al [27] and Kang et al [28] have reported that anastomotic leakage may occur in cases in which there is excess tension and pressure on the anastomotic site and that these conditions are more frequently observed in patients with excessive visceral fat because the thick mesentery creates tension on the anastomosis. In addition, a deeper surgical field in these patients, and preoperative comorbidities, such as cardiovascular disease or diabetes mellitus, which are frequently seen in obese patients, may affect the development of anastomotic leakage [29][30][31].…”

Gastric leakage after sleeve gastrectomy—clinical presentation and therapeutic options

“…Stroh et al [24] observed a leakage rate of 7% among 144 patients in which a laparoscopic sleeve gastrectomy was performed in a large German multicenter observational study. Table 3 shows the latest studies dealing with staple line leakage after laparoscopic sleeve gastrectomy for morbid obesity, its clinical appearance, and parameters and gives a short overview of the proceeded management of this operative complication [11,21,22,[24][25][26].…”

Sleeve Gastrectomy: Procedure, Outcomes, and Complications

“…The incidences of gastric leaks have been reported to range from 0.7% to 5%, with a mean of 2.3% [26]. A study done on 118 morbidly obese patients with a BMI greater than 30 kg/m 2 reported an overall gastric leak rate of 3.4% [27]. Comparatively, Frezza et al [28] performed LSG on 53 patients and reported a gastric leak rate of 3.7%.…”

“…In this case, management involves use of broadspectrum antibiotics, parenteral nutrition, high-dose proton pump inhibitors, and percutaneous drainage of fluid collections [32]. Another viable option to consider would be use of an endoluminal stent, which may be deployed to prevent leakage at the defective site to allow time for healing [27]. However, this treatment option may be limited by distal stent migration.…”