Abstract
Sleeve gastrectomy is a recently developed technique for treating morbid obesity. Since it is a simple procedure, the number of surgeons using it has grown in recent years. The patients who present fistulas after surgery often undergo a harrowing postoperative period as well as increased morbidity and mortality. Our aim was to assess the incidence, causes, diagnosis, management, and prevention of leaks after sleeve gastrectomy.
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Serra C, Pérez N, Bou R, et al. Gastrectomía tubular laparoscópica. Una operación bariátrica con diferentes indicaciones. Cir Esp. 2006;75(5):289–92.
Marceau P, Cabanac M, Frankham PC, et al. Accelerated satiation after duodenal switch. Surg Obes Relat Dis. 2005;1(4):408–12.
Hess DS, Hess DW. Biliopancreatic diversion with duodenal switch. Obes Surg. 1998;8:267–82.
Almogy G, Crookes PF, Anthone GJ. Longitudinal gastrectomy as a treatment for the high-risk super-obese patient. Obes Surg. 2004;14(4):492–7.
Gagner M, Patterson E. Laparoscopic biliopancreatic diversion with duodenal switch. Dig Surg. 2000;17:547–66.
Regan JP, Inabnet WB, Gagner M. Early experience with two-stage laparoscopic Roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.
Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15(8):1124–8.
Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18:1323–9.
Bruce J, Krukowski ZH, Al-Khairy G, et al. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg. 2001;88(9):1157–68.
Csendes A, Burdiles P, Burgos AM, et al. Conservative management of anastomotic leaks after 557 open gastric bypasses. Obes Surg. 2005;15(9):1252–6.
Tan JT, Kariyawasam S, Wijeratne T, et al. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20(4):403–9.
Burgos AM, Braghetto I, Csendes A, et al. Gastric leak after laparoscopic-sleeve gastrectomy for obesity. Obes Surg. 2009;19:1672–7.
Casella G, Soricelli E, Rizello M, et al. Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obes Surg. 2009;19:821–6.
Stroh C, Birk D, Flade-Kuthe R, et al. Results of sleeve gastrectomy—data from a nationwide survey on bariatric surgery in Germany. Obes Surg. 2009;19(5):632–40.
Yehoshua RT, Eidelman LA, Stein M, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18(9):1083–8.
Baltasar A, Bou R, Bengochea M, et al. Use of a Roux Limb to correct esophagogastric junction fistulas after sleeve gastrectomy. Obes Surg. 2007;17:1408–10.
Baker RS, Foote J, Kemmeter P, et al. The science of stapling and leaks. Obes Surg. 2004;14(10):1290–8.
Consten EC, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14(10):1360–6.
Armstrong J, O´Malley S. Outcomes of sleeve gastrectomy for morbid obesity: a safe and effective procedure? Int J Surg. 2010;8:69–71.
Sapala JA, Wood MH, Schuhknecht MP. Anastomotic leak prophylaxis using a vapor-heated fibrin sealant: report on 738 gastric bypass patients. Obes Surg. 2004;14(1):35–42.
Liu CD, Glantz GJ, Livingston EH. Fibrin glue as a sealant for high-risk anastomosis in surgery for morbid obesity. Obes Surg. 2003;13(1):45–8.
Gonzalez R, Nelson L, Gallagher S, et al. Anastomotic leaks after laparoscopic gastric bypass. Obes Surg. 2004;14:1299–307.
Moy J, Pomp A, Dakin G, et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196:e56–9.
Ballesta C, Berindoague R, Cabrera M, et al. Management of anastomotic leaks after laparoscopic Roux-en Y-bypass. Obes Surg. 2008;18:623–30.
Carucci LR, Turner MA, Conklin RC, et al. Roux-en-Y gastric bypass surgery for morbid obesity: evaluation of postoperative extraluminal leaks with upper gastrointestinal series. Radiology. 2006;238(1):119–27.
Carucci LR, Conklin RC, Turner MA. Roux-en-Y gastric bypass surgery for morbid obesity: evaluation of leak into excluded stomach with upper gastrointestinal examination. Radiology. 2008;248(2):504–10.
Serra C, Baltasar A, Andreo L, et al. Treatment of gastric leaks with coated self-expanding stents after sleeve gastrectomy. Obes Surg. 2007;17:866–72.
Papavramidis TS, Kotzampassi K, Kotidis E, et al. Endoscopic fibrin sealing of gastrocutaneous fistulas after sleeve gastrectomy and biliopancreatic diversion with duodenal switch. J Gastroenterol Hepatol. 2008;23(12):1802–5.
Fukumoto R, Orlina J, McGinty J, et al. Use of polyflex stents in treatment of acute esophageal and gastric leaks after bariatric surgery. Surg Obes Relat Dis. 2006;2:570–2.
Eubanks S, Edwards CA, Fearing NM, et al. Use of endoscopic stents to treat anastomotic complications after bariatric surgery. J Am Coll Surg. 2008;206(5):935–8.
Salinas A, Baptista A, Santiago E, et al. Self-expandable metal stents to treat gastric leaks. Surg Obes Relat Dis. 2006;2(5):570–2.
Blackmon SH, Santora R, Schwarz P, et al. Utility of removable esophageal covered self-expanding metal stents for leak and fistula management. Ann Thorac Surg. 2010;89(3):931–7.
Deitel M, Crosby RD, Gagner M. The first International Consensus Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–96.
Baltasar A, Serra C, Bengochea M, et al. Use of Roux limb as remedial surgery for sleeve gastrectomy fistulas. Surg Obes Relat Dis. 2008;4(6):759–63.
Hann SM, Ki WW, Oh J. Results of laparoscopic sleeve gastrectomy at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15:1469–75.
Hamoui N, Anthone GJ, Kaufman HS, et al. Sleeve gastrectomy in the high-risk patient. Obes Surg. 2006;16(11):1445–9.
Lalor PF, Tucker ON, Szomstein S, et al. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2008;1:33–8.
Kasalicky M, Michalsky D, Housova J, et al. Laparoscopic sleeve gastrectomy without over-sewing of the staple line. Obes Surg. 2008;18:1257–62.
Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.
Ser KH, Lee WJ, Lee YC, et al. Experience in laparoscopic sleeve gastrectomy for morbidly obese Taiwanese: staple-line reinforcement is important for preventing leakage. Surg Endos. 2010 (in press).
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Márquez, M.F., Ayza, M.F., Lozano, R.B. et al. Gastric Leak After Laparoscopic Sleeve Gastrectomy. OBES SURG 20, 1306–1311 (2010). https://doi.org/10.1007/s11695-010-0219-7
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DOI: https://doi.org/10.1007/s11695-010-0219-7