Skip to main content
Log in

Gastric Leak After Laparoscopic Sleeve Gastrectomy

  • Review
  • Published:
Obesity Surgery Aims and scope Submit manuscript

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Serra C, Pérez N, Bou R, et al. Gastrectomía tubular laparoscópica. Una operación bariátrica con diferentes indicaciones. Cir Esp. 2006;75(5):289–92.

    Article  Google Scholar 

  2. Marceau P, Cabanac M, Frankham PC, et al. Accelerated satiation after duodenal switch. Surg Obes Relat Dis. 2005;1(4):408–12.

    Article  PubMed  Google Scholar 

  3. Hess DS, Hess DW. Biliopancreatic diversion with duodenal switch. Obes Surg. 1998;8:267–82.

    Article  CAS  PubMed  Google Scholar 

  4. 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.

    Article  PubMed  Google Scholar 

  5. Gagner M, Patterson E. Laparoscopic biliopancreatic diversion with duodenal switch. Dig Surg. 2000;17:547–66.

    Article  Google Scholar 

  6. 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.

    Article  CAS  PubMed  Google Scholar 

  7. Baltasar A, Serra C, Pérez N, et al. Laparoscopic sleeve gastrectomy: a multi-purpose bariatric operation. Obes Surg. 2005;15(8):1124–8.

    Article  PubMed  Google Scholar 

  8. Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, efficacy, and safety of sleeve gastrectomy. Obes Surg. 2008;18:1323–9.

    Article  PubMed  Google Scholar 

  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.

    Article  CAS  PubMed  Google Scholar 

  10. 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.

    Article  PubMed  Google Scholar 

  11. 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.

    Article  PubMed  Google Scholar 

  12. Burgos AM, Braghetto I, Csendes A, et al. Gastric leak after laparoscopic-sleeve gastrectomy for obesity. Obes Surg. 2009;19:1672–7.

    Article  PubMed  Google Scholar 

  13. Casella G, Soricelli E, Rizello M, et al. Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obes Surg. 2009;19:821–6.

    Article  CAS  PubMed  Google Scholar 

  14. 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.

    Article  PubMed  Google Scholar 

  15. Yehoshua RT, Eidelman LA, Stein M, et al. Laparoscopic sleeve gastrectomy—volume and pressure assessment. Obes Surg. 2008;18(9):1083–8.

    Article  PubMed  Google Scholar 

  16. 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.

    Article  PubMed  Google Scholar 

  17. Baker RS, Foote J, Kemmeter P, et al. The science of stapling and leaks. Obes Surg. 2004;14(10):1290–8.

    Article  PubMed  Google Scholar 

  18. 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.

    Article  PubMed  Google Scholar 

  19. Armstrong J, O´Malley S. Outcomes of sleeve gastrectomy for morbid obesity: a safe and effective procedure? Int J Surg. 2010;8:69–71.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  PubMed  Google Scholar 

  21. 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.

    Article  PubMed  Google Scholar 

  22. Gonzalez R, Nelson L, Gallagher S, et al. Anastomotic leaks after laparoscopic gastric bypass. Obes Surg. 2004;14:1299–307.

    Article  PubMed  Google Scholar 

  23. Moy J, Pomp A, Dakin G, et al. Laparoscopic sleeve gastrectomy for morbid obesity. Am J Surg. 2008;196:e56–9.

    Article  PubMed  Google Scholar 

  24. Ballesta C, Berindoague R, Cabrera M, et al. Management of anastomotic leaks after laparoscopic Roux-en Y-bypass. Obes Surg. 2008;18:623–30.

    Article  PubMed  Google Scholar 

  25. 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.

    Article  PubMed  Google Scholar 

  26. 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.

    Article  PubMed  Google Scholar 

  27. 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.

    Article  PubMed  Google Scholar 

  28. 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.

    Article  PubMed  Google Scholar 

  29. 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.

    Article  Google Scholar 

  30. 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.

    Article  PubMed  Google Scholar 

  31. 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.

    Article  PubMed  Google Scholar 

  32. 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.

    Article  PubMed  Google Scholar 

  33. 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.

    Article  PubMed  Google Scholar 

  34. 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.

    Article  PubMed  Google Scholar 

  35. 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.

    Article  Google Scholar 

  36. Hamoui N, Anthone GJ, Kaufman HS, et al. Sleeve gastrectomy in the high-risk patient. Obes Surg. 2006;16(11):1445–9.

    Article  PubMed  Google Scholar 

  37. Lalor PF, Tucker ON, Szomstein S, et al. Complications after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2008;1:33–8.

    Article  Google Scholar 

  38. Kasalicky M, Michalsky D, Housova J, et al. Laparoscopic sleeve gastrectomy without over-sewing of the staple line. Obes Surg. 2008;18:1257–62.

    Article  PubMed  Google Scholar 

  39. Frezza EE, Reddy S, Gee LL, et al. Complications after sleeve gastrectomy for morbid obesity. Obes Surg. 2009;19:684–7.

    Article  PubMed  Google Scholar 

  40. 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).

Download references

Conflict of Interest Statement

All authors declare that they have no conflict of interest.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Manuel Ferrer Márquez.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11695-010-0219-7

Keywords

Navigation