Management of leak after sleeve gastrectomy: outcomes of 73 cases, treatment algorithm and predictors of resolution.

• DOI: 10.1007/s11695-019-04203-w
• Publication Date: 2019-11-09T22:02:59Z
• Authors: Moataz Bashah; Nesreen Khidir; Moamena EL-Matbouly
• Keywords: Sleeve gastrectomy; Jejunostomy

Abstract Introduction Gastric leak post laparoscopic sleeve gastrectomy (LSG) is a severe complication that has been reported in 1.5–3% of cases. Management algorithms exist; however, no known factors predict the time to resolution. This study aims share outcomes our management algorithm LSG leak, including rate resolution, complications, admission intensive care unit, conversion other techniques, and mortality. To determine if any can resolution time. Methods A retrospective analysis patients who had leaks was managed main tertiary center Qatar (January 2012–December 2017). Results total seventy-three leaks. Fifty-six (76.7%) underwent outside center. Thirteen (17.8%) were after revisional LSG. Laparoscopic exploration performed twenty (27.4%) feeding jejunostomy nine (12.3%). Patients followed up for 12 months. All healed within 8.8 ± 0.72 weeks. The (97.1%) without surgical conversion, while two required fistulo-jejunostomy. No patient died. Complications occurred; re-leak (14.9%) splenic abscess (2.9%). on jejunal shorter (HR = 2.7, P 0.018), parenteral nutrition post-endoscopic dilatation 66% 50% increases time; 0.34, 0.026) 0.5, 0.047), respectively. Conclusion post-LSG multimodal. Our clinical experience demonstrated less urge perform extensive interventions. enteral with stricture longer