Prevention and Management of Staple Line Leaks after Laparoscopic Sleeve Gastrectomy

Botaitis, Sotirios; Mitsala, Athanasia; Perente, Sempachedin; Simopoulos, Constantinos; Internationals, Ommega

doi:10.15436/2377-1364.18.1897

Cited by 5 publications

(7 citation statements)

References 52 publications

(92 reference statements)

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“…Furthermore, it has been agreed that tachycardia is the earliest and the most constant indicator of gastric leak. 14 The role of postoperative contrast swallow examinations is not conclusive and should be done only in case of clinical suspicion. 15 Abdominal computed tomography with contrast exhibits the best diagnostic accuracy.…”

Section: Discussionmentioning

confidence: 99%

Management and prevention of Leakage after Sleeve Gastrectomy

Diab¹,

Kaseer

2020

Al-Azhar International Medical Journal

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Section: Discussionmentioning

confidence: 99%

Management and prevention of Leakage after Sleeve Gastrectomy

Diab¹,

Kaseer

2020

Al-Azhar International Medical Journal

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“…Botaitis, et al [27] support primary surgical repair of the defect and immediate surgical intervention with wash out drainage and primary repair for patients with early leaks due to the fact that the surrounding tissues are still healthy.…”

Section: Discussionmentioning

confidence: 99%

Leakage after sleeve gastrectomy: Endoscopic stenting VS surgical intervention

Abdel‐Hamid¹,

Gharib²,

Mohammed³

et al. 2020

Arch Surg Clin Res

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Background: Laparoscopic sleeve gastrectomy (LSG) is becoming more popular in the treatment of obesity. LSG is safe with a low morbidity. The complications rarely result in morbidity and even mortality. Leaks are the major complication associated with LSG with a reported prevalence between 1.9% and 2.4%. Objective: To compare surgical intervention and endoscopic stenting for treatment of gastric leakage after sleeve gastrectomy. Patients and method: Our study included 30 patients presented with post sleeve leaks discovered by routine postoperative imaging or during the follow up period. Patients were recruited from October 6th university hospital during the period from August 2017 to August 2019. Patients were divided to the following groups: 1) Endoscopy group: This included 15 patients with post sleeve leakage undergoing endoscopic stent insertion. 2) Surgery group: which included 15 patients with post sleeve leak age undergoing surgical management. This division was random. Results: Our study showed that Endoscopic stenting for management of post sleeve gastrectomy leakage is an eff ective method with lower morbidity and shorter post-operative hospital stay than surgical management. Some patients may be good candidates for early surgical intervention in type 1 leakage if managed early before dissemination of leakage and before tissues become friable. Complications of stents include stent migration (26%), stent related ulcer (13%) and stricture (13%). while the surgical intervention carries more complications (DVT, chest infection, wound infection and stricture) and longer postoperative hospital stay. Conclusion: endoscopic management of post-sleeve gastrectomy leakage with stenting is recommended because it successfully manages the leaks and avoids invasive procedures with less risk, with shorter hospital stay and early return of function.

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“…11 The total appraisal chest X-ray images help ruling out different causes tachycardia such pneumonia, aspiration, embolism, or pleural affection. 12…”

Section: Introductionmentioning

confidence: 99%

Comparative Study between Surgical Intervention and Endoscopic Stenting for Management of Leakage after Sleeve Gastrectomy

Aziz

Mahmoud

2020

Ain Shams Journal of Surgery

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Objectives: To evaluate surgical intervention versus stents insertion in management of staple line leaks after laparoscopic sleeve gastrectomy in morbidly obese patients.Patients and methods: Prospective randomized study including 30 hemodynamically stable patients presented early post sleeve leaks discovered by routine postoperative imaging or during follow up period. Patients recruited from El-Demerdash university hospital and El Zahraa university hospital during period January 2014 to December 2018. Patients were divided in two equal ratio groups: Endoscopy group: included 15 patients post sleeve leakage underwent stent insertion and Surgery group: included 15 patients post sleeve leakage underwent surgical management.Results: Mean interval between Initial surgery and leak in endoscopy group was 4.5±2.7 days with most common site of leak GE junction (80%). Mean interval between Initial surgery and leak in surgery group was 4.6±2.2 days; while most common site leak, GE junction (73.3%) with no statistical significance. Leak closure was achieved in 13 (86.66%) in endoscopy group and only 2 patients required conversion R en Y with closure of leak and leak control within 3.3±5.5 days. Average hospital stay was 8.3 ±4.4 days. Leak closure achieved in 7 (46.6%) 13 (86.66%) in surgery group, seven patients required conversion to R en Y either from the start or after failure of direct suturing to control spillage, while one patients died. interval between closure of leak and leak control was 5 ±4.3 days. With average hospital stay 8.3 ±4.4 days. There was no statistically significant association between type of management and outcomes (p =0.51). In contrary, there was statistically significant association between type of management and interval for leak control (p <0.001) and hospital stay (p=0.012). There was no statistically significant association between the site of leak in both groups (p=0.48). Conclusion:Stenting is a better choice for spillage patients who are essentially steady. It is less dangerous than surgical procedure.

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Prevention and Management of Staple Line Leaks after Laparoscopic Sleeve Gastrectomy

Cited by 5 publications

References 52 publications

Management and prevention of Leakage after Sleeve Gastrectomy

Management and prevention of Leakage after Sleeve Gastrectomy

Leakage after sleeve gastrectomy: Endoscopic stenting VS surgical intervention

Comparative Study between Surgical Intervention and Endoscopic Stenting for Management of Leakage after Sleeve Gastrectomy

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