Successful Management of a Gastric Sleeve Leak with an Endoscopic Stent

Abraham, Albin; Rizvon, Kaleem; Singh, Jaspreet; Siddiqui, Ghulam; Prasad, Apsara; Rashid, Sadat; Vardaros, Magdalene; Garg, Vikas; Subramani, Krishnaiyer; Mustacchia, Paul

doi:10.1155/2012/205979

Cited by 10 publications

(6 citation statements)

References 9 publications

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“…Currently, the standard treatment of gastric staple line dehiscence is surgical exploration,[ 14 ] although there are reports of successful therapy with endoscopic stent placement. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

The role of esophageal stent placement in the management of postesophagectomy anastomotic leak

Al-issa¹,

Petersen²,

Taha³

et al. 2014

Saudi J Gastroenterol

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Background/Aim:Anastomotic leak after esophagectomy is one of the most challenging complications resulting in a high morbidity and mortality and prolonged hospitalization. The study intended to assess the outcome of endoluminal self-expanding stent in the treatment of this problem.Settings and Design:Department of Thoracic and Cardiovascular Surgery, Arhus University Hospital, Skejby, Arhus, Denmark. A retrospective study.Patients and Methods:From January 2007 to December 2010, 209 patients underwent esophagectomy for malignant disease of the esophagus or the cardia. Twenty patients developed anastomotic leak. Treatment consisted of conservative measures, surgery, and stent placement. Details of treatment, clinical outcome, complications, and mortality were evaluated.Statistical analysis:None.Results:One hundred and forty-seven patients (70.3%) had carcinoma of the cardia, whereas 62 patients (29.7%) had esophageal carcinoma. Twenty patients (9.5%) developed anastomotic leak; small (<1 cm) in two patients (10%); managed conservatively and bigger than 1 cm in 15 patients (75%); treated with an esophageal stent (Hanaro stent, DIAGMED Healthcare, Thirsk, YO7 3TD, United Kingdom). In three patients (15%), perforation of the staple line of the intrathoracic gastric conduit was found and managed by reoperation. Functional sealing of anastomoses after stent placement could be achieved in 10 patients (67%). Stent-related morbidity developed in five patients (33%): Migration of the stent, n=3 and tracheoesophageal fistula, n=2. Stents were smoothly removed 3 weeks after discharge. The mean hospital stay was 25 days. There was only one stent-related death (6.6%).Conclusion:Endoluminal stent implantation is an effective and safe option in the management of postesophagectomy leaks.

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“…Currently, the standard treatment of gastric staple line dehiscence is surgical exploration,[ 14 ] although there are reports of successful therapy with endoscopic stent placement. [ 15 ]…”

Section: Discussionmentioning

confidence: 99%

The role of esophageal stent placement in the management of postesophagectomy anastomotic leak

Al-issa¹,

Petersen²,

Taha³

et al. 2014

Saudi J Gastroenterol

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“…The probability of a leakage amongst operations performed at our clinic is determined about 2.8%. The treatment methods of gastric leakage are variable and are designated depending on the dimension of the leakage, the extent of the abdominal contamination, and the location of the leakage [5]. To determine a leakage at an early stage, patients at our clinic drink water-soluble opaque matter and are screened under fluoroscopy on the first day after surgery.…”

Section: Discussionmentioning

confidence: 99%

“…Methylene blue test, together with oral opaque matter under fluoroscopy and abdominal CT examinations may be helpful in determining leakages. Leakages determined at an early stage have an urgent surgical intervention indication, but most patients with late determination are managed with medical treatment [5]. For early stage leakages abdominal irrigation by laparoscopic exploration, a repair of the leakage if possible, and applying a jejunostomy for internal feeding is the most effective method.…”

Section: Discussionmentioning

confidence: 99%

Treatment Methods for Leakage Occurring at Staple Line After Laparoscopic Sleeve Gastrectomy

Erol¹,

Aydın²,

Uğurlu³

et al. 2015

J Curr Surg

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In this presentation, medical literature regarding this topic was reviewed along with the evaluation of treatment methods used in two specific cases during which leakages occurred along the staple line after laparoscopic sleeve gastrectomy (LSG). One of the two patients who developed a leakage after LSG was a 26-year-old female (case 1) and the other was a 20-year-old female (case 2). Case 1 was explored, when a leakage was diagnosed through clinical and screening procedures on day 3 after the surgery. After determining the leakage, the defect was primarily sutured and a feeding jejunostomy was placed. Case 1 developed leakage again on the fourth day after the second surgery, an esophagogastric stent was performed three times whose drainage was cut off from the leakage line, and the patient was discharged with full recovery. However, case 2 then developed leakage on the 14th day after surgery. Next an esophagogastric stent was placed in the patient, and a computer tomography (CT)-guided percutaneous drainage was placed to drain the collections inside the abdomen. Four weeks after this procedure, the stent was removed and after specifying that the leakage had closed, the patient was discharged with full recovery. The treatment methods of gastric leakages after LSG are also variable, and the treatment method is designated depending on the dimension of the leakage, the extent of the abdominal contamination, and the location of the leakage.

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“…130 Revisional bariatric surgery is usually suitable for patients with chronic leaks, which is hard to treat through endoscopic treatment. 131 The three common revisions for chronic GL are laparoscopic Roux-En-Y Esophago-Jejunostomy (LRYEJ), RYGB, and total or near total gastrectomy with esophagojejunal anastomosis. Surgical treatment remains a difficult procedure with a high percentage of leakage but is easily tolerated by a patient and facilitates the healing of the fistula.…”

Section: Revisional Surgeries For Gastric Leakmentioning

confidence: 99%

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

Li¹,

Jiao²,

Zhang³

et al. 2021

DMSO

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Bariatric surgery has become increasingly common due to the worldwide obesity epidemic. A shift from open to laparoscopic surgery, specifically, laparoscopic sleeve gastrectomy (LSG), has occurred in the last two decades because of the low morbidity and mortality rates of LSG. Although LSG is a promising treatment option for patients with morbid obesity due to restrictive and endocrine mechanisms, it requires modifications for a subset of patients because of weight regain and tough complications, such as gastroesophageal reflux, strictures, gastric leak, and persistent metabolic syndrome., Revision surgeries have become more and more indispensable in bariatric surgery, accounting for 7.4% in 2016. Mainstream revisional bariatric surgeries after LSG include Roux-en-Y gastric bypass, repeated sleeve gastrectomy, biliopancreatic diversion, duodenal switch, duodenal-jejunal bypass, one-anastomosis gastric bypass, single anastomosis duodeno-ileal bypass (SAID) and transit bipartition. This review mainly describes the revisional surgeries of LSG, including the indication, choice of surgical method, and subsequent effect.

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Successful Management of a Gastric Sleeve Leak with an Endoscopic Stent

Cited by 10 publications

References 9 publications

The role of esophageal stent placement in the management of postesophagectomy anastomotic leak

The role of esophageal stent placement in the management of postesophagectomy anastomotic leak

Treatment Methods for Leakage Occurring at Staple Line After Laparoscopic Sleeve Gastrectomy

Revisional Surgeries of Laparoscopic Sleeve Gastrectomy

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