Staple Line Leak After Primary Sleeve Gastrectomy—Risk Factors and Mid-term Results: Do Patients Still Benefit from the Weight Loss Procedure?

  • Frank Benedix
  • Oliver Poranzke
  • Daniele Adolf
  • Stephanie Wolff
  • Hans Lippert
  • Jörg Arend
  • Thomas Manger
  • Christine Stroh
  • Obesity Surgery Working Group Competence Network Obesity
Original Contributions

DOI: 10.1007/s11695-017-2543-7

Cite this article as:
Benedix, F., Poranzke, O., Adolf, D. et al. OBES SURG (2017). doi:10.1007/s11695-017-2543-7

Abstract

Background

Staple line leak after laparoscopic sleeve gastrectomy (LSG) still represents the most feared complication. The purpose of this study was to investigate whether there are factors that increase the risk for a leakage. Furthermore, we aimed to analyze the impact of a leak on weight change and resolution of comorbidities.

Methods

Since 2005, data from obese patients that undergo bariatric procedures in Germany are prospectively registered. For the current analysis, all adult subjects that had undergone primary LSG from 2005 to 2014 were considered.

Results

Overall, 241/15,756 (1.53%) patients experienced a leak. The occurrence of a leakage resulted in a significant increase of the mortality rate (3.7 vs. 0.2%; p < 0.01). Percent excess weight loss did not differ between leak and non-leak patients, both, at 12 (64.2 vs. 60.9%; p = 1.0) and 24 months (68.5 vs. 64.0%, p = 0.86). Similarly, no significant difference was observed for resolution rate of all comorbid conditions. Matched pair analysis confirmed these findings. Multivariable analysis identified operation time, conversion, intraoperative complications, and hypertension and degenerative joint disease as risk factors for a leak. Oversewing the staple line was associated with the lowest risk.

Conclusion

The postoperative staple line leak after primary LSG significantly increases postoperative morbidity and mortality. We found that there are patient-related factors and operative variables that predispose to leakage after LSG. However, the occurrence of a leakage does not adversely impact the weight loss and resolution of comorbidities in the mid-term.

Keywords

Sleeve gastrectomy Leakage Outcome Risk factors German multicenter trial 

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Frank Benedix
    • 1
  • Oliver Poranzke
    • 1
  • Daniele Adolf
    • 2
  • Stephanie Wolff
    • 1
  • Hans Lippert
    • 1
  • Jörg Arend
    • 1
  • Thomas Manger
    • 3
  • Christine Stroh
    • 3
  • Obesity Surgery Working Group Competence Network Obesity
  1. 1.Department of SurgeryUniversity Hospital MagdeburgMagdeburgGermany
  2. 2.StatConsult MagdeburgMagdeburgGermany
  3. 3.SRH Municipal Hospital GeraGeraGermany