Abstract
Laparoscopic sleeve gastrectomy (LSG) has been performed as a stand-alone primary bariatric procedure with increasing frequency. Staple line leakage is the most terrifying complication of the operation. In this study, three cases of proximal gastric leak after LSG treated by uncovered biodegradable polydioxanone stent under fluoroscopic and endoscopic guidance were analysed retrospectively. Endoscopic stenting is an efficacious minimally invasive method in the treatment of post-sleeve proximal gastric leaks and associated with rapid patient recovery and short hospital stay duration. Moreover, biodegradable stents are of major advantage with no need to be withdrawn.
Résumé
La sleeve gastrectomie par laparoscopie est de plus en plus souvent adoptée comme traitement chirurgical bariatrique. La fistule sur la ligne d’agrafage est la complication la plus grave. Cette étude analyse rétrospectivement trois cas de fistule gastrique proximale après une sleeve gastrectomie par laparoscopie, traités au moyen d’une prothèse en polydioxanone biodégradable non couverte, par endoscopie sous contrôle fluoroscopique. La pose d’une prothèse par endoscopie est une méthode efficace très peu invasive pour traiter une fistule gastrique proximale après une sleeve gastrectomie. Elle est associée à un prompt rétablissement des patients et à une hospitalisation courte. En outre, les endoprothèses biodégradables présentent l’avantage de ne pas requérir d’extraction.
References
Brethauer SA. Sleeve gastrectomy. Surg Clin N Am 2011;91: 1265–79.
Shi X, Karmali S, Sharma AM, Birch DW. A review of laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 2010;20:1171–7.
Kim Z, Kim YJ, Kim YJ, Goo DE, Cho JY. Successful management of staple line leak after laparoscopic sleeve gastrectomy with vascular plug and covered stent. Surg Laparosc Endosc Percutan Tech 2011;21:206–8.
Jurowich C, Thalheimer A, Seyfried F, Fein M, Bender G, Germer CT, et al. Gastric leakage after sleeve gastrectomy-clinical presentation and therapeutic options. Langenbecks Arch Surg 2011;396:981–7
Nguyen NT, Nguyen XM, Dholakia C. The use of endoscopic stent in management of leaks after sleeve gastrectomy. Obes Surg 2010;20:1289–92.
Abraham A, Rizvon K, Singh J, Siddiqui G, Prasad A, Rashid S, et al. Successful management of a gastric sleeve leak with an endoscopic stent. Case Rep Gastrointest Med 2012;2012:205979.
Simon F, Siciliano I, Gillet A, Castel B, Coffin B, Msika S. Gastric leak after laparoscopic sleeve gastrectomy: early covered selfexpandable stent reduces healing time. Obes Surg 2013;23:687–92.
Serra C, Baltasar A, Andreo L. Treatment of gastric leaks with coated self-expanding stents after sleeve gastrectomy. Obes Surg 2007;17:866–72.
Eubanks S, Edwards CA, Fearing NM, Ramaswamy A, de la Torre RA, Thaler KJ, et al. Use of endoscopic stents to treat anastomotic complications after bariatric surgery. J Am Coll Surg 2008;206:935–8.
Tan JT, Kariyawasam S, Wijeratne T, Chandraratna HS. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg 2010;20:403–9.
Lorenzo-Zúñiga V, Moreno-de-Vega V, Marín I, Boix J. Biodegradable stents in gastrointestinal endoscopy. World J Gastroenterol 2014;20:2212–7.
Rejchrt S, Kopacova M, Bartova J, Bures J. Intestinal biodegradable stents: initial experience in the Czech Republic. Folia Gastroenterol Hepatol 2009;7:7.
Author information
Authors and Affiliations
Corresponding author
About this article
Cite this article
Aras, A., Oran, E., Bozkurt, M.A. et al. Successful treatment of post-sleeve gastric leak with an uncovered biodegradable stent. Acta Endosc 44, 382–384 (2014). https://doi.org/10.1007/s10190-014-0399-4
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10190-014-0399-4