Outcome of Leaks After Sleeve Gastrectomy Based on a New Algorithm Addressing Leak Size and Gastric Stenosis
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We welcomed with great interest the masterpiece of Nedelcu et al.  concerning the outcome of leaks after laparoscopic sleeve gastrectomy (LSG) based on a new algorithm addressing leak size and gastric stenosis. The article stressed the importance of adopting this new algorithm in order to standardize leak management, thus reducing the number of endoscopic procedures. We agree with the authors about the use of endoscopic internal drainage (EID) by means of double pigtail to achieve complete healing. As already reported by our team , since March 2013, we adopted EID as the only endoscopic treatment in case of fistulas after LSG or gastric bypass, irrespective to leak size.
Moreover, we believe in the importance of introducing a well-defined algorithm in order to standardize the endoscopic treatment modality for leak following bariatric surgery.
KeywordsBariatric Surgery Laparoscopic Sleeve Gastrectomy Fistula Defect Double Pigtail Large Orifice
Conflict of Interest
The authors declare that they have no competing interests.
Endoscopic exploration of cardial zone showing no fistula and complete re-epithelialization of a 2 cm staple line dehiscence (MOV 10037 kb)
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