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Corresponding Author

Diab, Ahmed

Document Type

Original Article

Abstract

Abstract Background: Sleeve gastrectomy (SG) is currently the most commonly performed bariatric surgery. Postoperative leak is one of the most serious complications. Knowledge of the clinical presentation, together with the postoperative anatomy is crucial for the prevention, early diagnosis and proper management of this potentially life-threatening complication. AIM: The aim of this study was to determine the lines of management and prevention of leakage after sleeve gastrectomy. Methods: Morbid obese patients (BMI > 35) with associated health problems or (BMI > 40) with high risk of associated health problems were included in the study. Data was collected from medical records including age, sex, MBI, preoperative comorbidities, operative findings, postoperative follow up, interval between surgery and leak and the onset and site of leak, management lines and outcomes. RESULTS: The study included 20 patients. Half (50%) of patients showed intraoperative positive leak test and required stable line reinforcement. Postoperative follow up revealed leak in all (100%) of patients. First line management of leak was laparoscopic abscess drainage (30%), bleeding control (30%), Pigtail drainage (20%), and fistula repair and reinforcement (20%). The reported most common complications of leak management in the studied patients were failure of 1st line management (90%), stent migration in 3 (15%), stent related ulcer and stricture in 1 (5%) each. CONCLUSION:Based on these findings, we concluded that most cases of gastric leak after SG could be successfully managed by endoscopic esophageal mega stent. However, chronic leak is a serious complication associated with prolonged hospitalization, cost, and unfavorable outcomes.

Keywords

Keywords:(Sleeve Gastrectomy; Gastric Leak; Diagnosis; Treatment; Outcomes)

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