Successful Management of Staple Line Leak After Laparoscopic Sleeve Gastrectomy With Vascular Plug and Covered Stent

• DOI: 10.1097/sle.0b013e3182258bf5
• Publication Date: 2011-10-04T18:57:32Z
• Authors: Zisun Kim; Yong Jin Kim; Yong Jae Kim; Dong Erk Goo; Joo Young Cho
• Keywords: Male; Reoperation; Sutures; Suture Techniques; Anastomotic Leak; Obesity, Morbid; 3. Good health; Young Adult; 03 medical and health sciences; 0302 clinical medicine; Coated Materials, Biocompatible; Gastrectomy; Humans; Laparoscopy; Stents; Treatment Failure; Follow-Up Studies

Laparoscopic sleeve gastrectomy (LSG) is a feasible option for morbid obesity. But gastric leak is one of the most dreadful complications. We report our experience of staple line leak, which was managed successfully with vascular plug and covered stent.A staple line leak occurred after LSG. Followed attempts of reoperation, drainage procedures of abscess cavity, and repeated endoscopic treatments were all unavailing. Finally, vascular plug was placed at fistula tract and consequent endoscopic covered stent placement could propose the solution.Granulation tissue, which occluded the fistula tract was identified by computed tomographic scan 2 weeks after stent placement. Leak healed successfully, and the patient discharged safely a week after stent removal.We consider inducing granulation tissue by applying vascular plug at fistula tract in combination with covered stent placement, which is a safe and effective therapeutic option for management of intractable staple line leak after LSG.