MANAGEMENT OF STAPLE LINE LEAKS FOLLOWING SLEEVE GASTRECTOMY
Basrah Journal of Surgery,
2018, Volume 24, Issue 1, Pages 57-62
AbstractMANAGEMENT OF STAPLE LINE LEAKS FOLLOWING SLEEVE GASTRECTOMY
Nasseif Jassim Mohammed@ & Falih M Algazgooz* @MB,ChB, CABS, FICMS, General and Laparoendoscopic Surgeon, Al-Sadr Teaching Hospital. *MB,ChB, CABS, FICMS, FACS, MRCS, Consultant Bariatric and Laparoendoscopic Surgeon, Al-Sadr Teaching Hospital, Basrah, IRAQ.
Abstract Bariatric surgery is a growing specialty and the number of laparoscopic sleeve gastrectomies (LSG) has increased dramatically in the latest years all over the world. Gastric leak is considered one of the most serious complications following laparoscopic sleeve gastrectomy, it can become chronic, recurrent, and need multiple interferences. The purpose of the present study is to determine the clinical presentation of gastric leak after LSG, its management, postoperative course, and to show the effectiveness of various ways of managing such complication. This study included 200 patients who underwent sleeve gastrectomy at Al-Sadr Teaching Hospital for morbid obesity, they were 60 males(30%) and 140 females(70%). The mean age was 35 years and the mean body mass index (BMI) was 39 kg/m2. Out of the 200 patients who underwent laparoscopic sleeve gastrectomy, 6 patients (3%) were recognized to have leak complication. All leaks were proximal and identified at the gastroesophageal junction. Management was accomplished by putting T tube at the site of leak for 2 patients, direct closure for one patient, just drainage for one patient, and Roux-en-Y Gastric Bypass (RYGB) for the remaining 2 patients. In conclusion, prompt diagnosis and treatment is vital in the management of a leak. However, it can be treated securely via numerous management ways depending on the time of diagnosis and magnitude of the leakage.
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