BACKGROUND: Obesity today is a leading cause of global morbidity and mortality, and bariatric surgeries such as laparoscopic sleeve gastrectomy (LSG) are increasingly playing a key role in its management. Such operations, however, carry many difficult and sometimes fatal complications, including leaks. This study aims at evaluating the effectiveness of endoscopic stenting in treating gastric leaks post-LSG. METHODS: A retrospective study was conducted to the patients who were admitted with post-LSG gastric leak at Al-Amiri Hospital Kuwait from October 2008 to December 2012 and were subsequently treated with stenting. The patients were stented endoscopically with self-expandable metal stent (SEMS), and a self-expandable plastic stent (SEPS) was used to facilitate stent removal. RESULTS: A total of 17 patients with post-LSG leaks underwent endoscopic stenting. The median age was 34 years (range 19-56), 53% of the patients were male, and mean body mass index (BMI) was 43 kg/m(2). The median duration of SEMS placement per patient was 42 days (range 28-84). The SEPS-assisted retrieval process took a median duration of 11 days (range 14-35). Successful treatment of gastric leak was evident in 13 (76%) patients, as evident by gastrografin swallow 1 week after stent removal. In addition, a shorter duration between the LSG and the time of stent placement was associated with a higher success rate of leak seal. CONCLUSIONS: The use of SEMS appears to be a safe and effective method in the treatment of post-LSG leaks, with a success rate of 76%. The time frame of intervention after surgery is critical, as earlier stent placement is associated with favorable outcomes. Finally, SEPS is often required to facilitate SEMS removal, and further modification of stents and its delivery system may improve results.
BACKGROUND: Obesity today is a leading cause of global morbidity and mortality, and bariatric surgeries such as laparoscopic sleeve gastrectomy (LSG) are increasingly playing a key role in its management. Such operations, however, carry many difficult and sometimes fatal complications, including leaks. This study aims at evaluating the effectiveness of endoscopic stenting in treating gastric leaks post-LSG. METHODS: A retrospective study was conducted to the patients who were admitted with post-LSG gastric leak at Al-Amiri Hospital Kuwait from October 2008 to December 2012 and were subsequently treated with stenting. The patients were stented endoscopically with self-expandable metal stent (SEMS), and a self-expandable plastic stent (SEPS) was used to facilitate stent removal. RESULTS: A total of 17 patients with post-LSG leaks underwent endoscopic stenting. The median age was 34 years (range 19-56), 53% of the patients were male, and mean body mass index (BMI) was 43 kg/m(2). The median duration of SEMS placement per patient was 42 days (range 28-84). The SEPS-assisted retrieval process took a median duration of 11 days (range 14-35). Successful treatment of gastric leak was evident in 13 (76%) patients, as evident by gastrografin swallow 1 week after stent removal. In addition, a shorter duration between the LSG and the time of stent placement was associated with a higher success rate of leak seal. CONCLUSIONS: The use of SEMS appears to be a safe and effective method in the treatment of post-LSG leaks, with a success rate of 76%. The time frame of intervention after surgery is critical, as earlier stent placement is associated with favorable outcomes. Finally, SEPS is often required to facilitate SEMS removal, and further modification of stents and its delivery system may improve results.
Authors: Xabier de Aretxabala; Jorge Leon; Gonzalo Wiedmaier; Ivan Turu; Cristian Ovalle; Fernando Maluenda; Carolina Gonzalez; Jennifer Humphrey; Mabel Hurtado; Carlos Benavides Journal: Obes Surg Date: 2011-08 Impact factor: 4.129
Authors: A Pequignot; D Fuks; P Verhaeghe; A Dhahri; O Brehant; E Bartoli; R Delcenserie; T Yzet; J-M Regimbeau Journal: Obes Surg Date: 2012-05 Impact factor: 4.129
Authors: Murad A Aburajab; Joshua B Max; Mel A Ona; Kapil Gupta; Miguel Burch; F Michael Feiz; Simon K Lo; Laith H Jamil Journal: Dig Dis Sci Date: 2017-08-16 Impact factor: 3.199
Authors: Hytham K S Hamid; Sameh H Emile; Alan A Saber; Mürşit Dincer; Diogo T H de Moura; Lennard P L Gilissen; Majid A Almadi; Mauro Montuori; Michel Vix; Luis G S Perisse; Nicolás Quezada; Fabio Garofalo; Radu Pescarus Journal: Surg Endosc Date: 2020-11-06 Impact factor: 4.584