Use of Self-Expandable Metal Stents in the Treatment of Leaks Complicating Laparoscopic Sleeve Gastrectomy: A Cohort Study

Almadi, Majid A; Bamihriz, Fahad; Alharbi, Othman; Azzam, Nahla; Aljammaz, Ahmed; Eltayeb, Mohanned; Thaniah, Salem; Aldohayan, Abdullah; Aljebreen, Abdulrahman

doi:10.1007/s11695-017-3054-2

Cited by 14 publications

(21 citation statements)

References 21 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Other severe complications of stent implantation were rare. One reported gastrointestinal perforation [38]. Two studies showed minor bleeding as a complication of stenting [32,34].…”

Section: Discussionmentioning

confidence: 99%

“…Leaks were most often located within the gastroesophageal junction (GEJ) near the proximal end of the staple line or in the distal portion of the esophagus, or in the upper third of the gastric stump. The mean [38].…”

Section: Self-expanding Metal and Plastic Stentsmentioning

confidence: 99%

“…Also, the funnel plot, the sensitivity analysis, and the Begg's test suggested an existing bias and asymmetry (Supplementary material: Figures S7 and S8). Therefore, several studies, which contributed to heterogeneity the most and were located outside the funnel, were excluded [21,23,24,26,34,38,40,63]. After excluding the above studies, the remaining studies appeared to be homogeneous (I 2 = 3.36%, p = 0.41) and the overall proportion wasn't changed, but the precision increased and the confidence interval become narrower-proportion of stent migration = 23% (95% CI, 19-28%).…”

Section: Stent Migrationmentioning

confidence: 99%

See 2 more Smart Citations

Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

Background Endoscopic techniques have become the first-line therapy in bariatric surgery-related complications such as leaks and fistulas. We performed a systematic review and meta-analysis on the effectiveness of self-expandable stents, clipping, and tissue sealants in closing of post-bariatric surgery leak/fistula. Methods A systematic literature search of the Medline/Scopus databases was performed to identify full-text articles published up to February 2019 on the use of self-expandable stents, clipping, or tissue sealants as primary endoscopic strategies used for leak/fistula closure. Meta-analysis of studies reporting stents was performed with the PRISMA guidelines. Results Data concerning the efficacy of self-expanding stents in the treatment of leaks/fistulas after bariatric surgery were extracted from 40 studies (493 patients). The overall proportion of successful leak/fistula closure was 92% (95% CI, 90-95%). The overall proportion of stent migration was 23% (95% CI, 19-28%). Seventeen papers (98 patients) reported the use of clipping: the over-the-scope clips (OTSC) system was used in 85 patients with a successful closure rate of 67.1% and a few complications (migration, stenosis, tear). The successful fistula/leak closure using other than OTSC types was achieved in 69.2% of patients. In 10 case series (63 patients), fibrin glue alone was used with a 92.8-100% success rate of fistula closure that usually required repeated sessions at scheduled intervals. The complications of fibrin glue applications were reported in only one study and included pain and fever in 12.5% of patients. Conclusions Endoscopic techniques are effective for management of post-bariatric leaks and fistulas in properly selected patients.

show abstract

“…Other severe complications of stent implantation were rare. One reported gastrointestinal perforation [38]. Two studies showed minor bleeding as a complication of stenting [32,34].…”

Section: Discussionmentioning

confidence: 99%

Section: Self-expanding Metal and Plastic Stentsmentioning

confidence: 99%

Section: Stent Migrationmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis

et al. 2020

View full text Add to dashboard Cite

show abstract

“…Multiple studies have described the efficacy and safety of using partially and fully covered (FC) esophageal self-expandable metallic stents (SEMSs) in the management of post-LSG leakage and stenosis. [ 6 7 8 9 ] However, only a few studies have reported the efficacy of specifically designed FC mega SEMS in the management of post-LSG leakage and stenosis. [ 10 11 12 ] Thus, the present study aimed to assess the efficacy and safety profile of using the mega stent in the management of post-LSG fistulas and stenosis in a single center.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies in Saudi Arabia have only reported the use of partially covered SEMS in the management of post-LSG leak. [ 8 ]…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Management of Post-Laparoscopic Sleeve Gastrectomy Leakage and Stenosis Using Fully Covered Stent

Aljahdli

AlDabbagh

Salah

et al. 2021

Saudi Journal of Medicine &Amp; Medical Sciences

View full text Add to dashboard Cite

Background: Laparoscopic sleeve gastrectomy (LSG) is the most commonly performed surgery to treat morbid obesity. Post-LSG leak and stenosis are serious complications that can be associated with significant morbidity and mortality. Objective: The objective was to report the efficacy and safety profile of using specifically designed fully covered self-expandable metallic stent for the treatment of post-LSG complications. Methods: This retrospective study included adult patients who underwent placement of a fully covered esophagogastric, self-expandable metallic stent for post-LSG leak or stenosis. The procedure was carried out at King Abdulaziz University Hospital, Jeddah, Saudi Arabia, between September 2017 and May 2019. Data regarding demographics, indication for stenting, size of the stent, procedural success and poststenting adverse events were collected. Results: A total of 14 patients met the inclusion criteria, with indication for endoscopic stenting being post-LSG leak in 11 patients and stenosis in 3 patients. The technical success rate of self-expandable metallic stent placement was 100%, and the clinical success was 85.7% (12 of 14 patients). Nausea (71.4%) and vomiting (85.7%) were the most frequent mild adverse events reported. Stent-induced esophageal stricture was the only major adverse event reported in two patients. Conclusion: Placement of specifically designed self-expandable metallic stent for the treatment of post-LSG leak and stenosis is an effective and safe approach. Further studies with larger cohorts are needed to assess the optimal duration needed to treat such complications.

show abstract

Customized bariatric stents for sleeve gastrectomy leak: are they superior to conventional esophageal stents? A systematic review and proportion meta-analysis

Hamid¹,

Emile

Saber

et al. 2020

Surg Endosc

View full text Add to dashboard Cite

Use of Self-Expandable Metal Stents in the Treatment of Leaks Complicating Laparoscopic Sleeve Gastrectomy: A Cohort Study

Abstract: Repeated stenting for leaks after LSG is an effective and safe intervention. The efficacy of partially covered SEMS appears superior to that of the fully covered SEMS.

Cited by 14 publications

References 21 publications

Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis

Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis

Endoscopic Management of Post-Laparoscopic Sleeve Gastrectomy Leakage and Stenosis Using Fully Covered Stent

Customized bariatric stents for sleeve gastrectomy leak: are they superior to conventional esophageal stents? A systematic review and proportion meta-analysis

Contact Info

Product

Resources

About