Obesity Surgery

, Volume 21, Issue 8, pp 1232–1237 | Cite as

Gastric Leak After Sleeve Gastrectomy: Analysis of Its Management

  • Xabier de Aretxabala
  • Jorge Leon
  • Gonzalo Wiedmaier
  • Ivan Turu
  • Cristian Ovalle
  • Fernando Maluenda
  • Carolina Gonzalez
  • Jennifer Humphrey
  • Mabel Hurtado
  • Carlos Benavides
Clinical Research

Abstract

Background

Bariatric surgery is increasingly being performed and sleeve gastrectomy (SG) has proved to be effective and safe. Among its complications, leaks are the most serious and life threatening.

Methods

The focus of the study is nine patients who underwent a SG and developed a gastric leak after surgery. Our data were obtained from the clinical charts of the patients and through interviews with the surgeon who performed the index surgery.

Results

Eight patients underwent SG at outside institutions while one was operated at Clinica Alemana. Three patients developed symptoms within 5 days after surgery, while the rest were diagnosed after 10 days from the surgery. A CT scan was the method used to confirm the diagnosis in all patients. The three patients who had a leak detected during the immediate postoperative period underwent laparoscopic reoperation. Among the rest of the patients, percutaneous drainage was employed in one patient as the primary procedure while the other underwent surgical drainage. An esophageal endoluminal stent was employed in four patients. The leak closed in all patients with the healing time ranging from 21 to 240 days.

Conclusions

Diagnosis of a leak after a SG required a greater index of suspicion in order to perform an early diagnosis. Sepsis control and nutritional support are the cornerstones of this treatment. Evolution is characterized by longer periods of time that are necessary in order to wait until the leak closes. Management must be tailored to each patient.

Keywords

Sleeve gastrectomy Leak Morbid obesity Bariatric surgery Stents 

Notes

Conflict of Interest

All authors declare that they have no conflict of interest.

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Copyright information

© Springer Science + Business Media, LLC 2011

Authors and Affiliations

  • Xabier de Aretxabala
    • 1
    • 2
    • 3
  • Jorge Leon
    • 1
  • Gonzalo Wiedmaier
    • 1
  • Ivan Turu
    • 1
  • Cristian Ovalle
    • 2
  • Fernando Maluenda
    • 1
    • 3
  • Carolina Gonzalez
    • 1
  • Jennifer Humphrey
    • 1
  • Mabel Hurtado
    • 2
  • Carlos Benavides
    • 1
  1. 1.Obesity UnitClinica AlemanaSantiagoChile
  2. 2.Department of SurgeryAir Force HospitalSantiagoChile
  3. 3.Department of SurgeryUniversidad de Chile HospitalSantiagoChile

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