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Outcome of Leaks After Sleeve Gastrectomy Based on a New Algorithm Adressing Leak Size and Gastric Stenosis

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Abstract

Background

Leaks after laparoscopic sleeve gastrectomy (LSG) are estimated to be the most serious complication of this procedure due to difficult healing process using non-standardized endoscopic approaches. Initially, endoscopic management recommended the use of stents.

Methods

A total of 19 patients received endoscopic treatment after LSG to manage leaks. The leak was classified depending on the primary orifice’s size (more or less than 10 mm) or on the presence of gastric stenosis. The primary aim was to develop a therapeutic algorithm in order to reduce the number of endoscopic procedures.

Results

The average number of endoscopic procedures was 2.8 (range 2–5) in group A (leak size <10 mm) and 4 (range 3–7) in group B (leak size >10 mm). Two out of 13 patients had stent migration (15.4 %) and required an additional procedure, one in group A and another in group B.

The average duration to achieve complete healing was 3.4 months (range 2–14 months), 2.8 months for group A and 3.9 months for group B.

Conclusions

Limited data can be found in the literature on leaks after LSG. A new algorithm based on leak size permits standardization of endoscopic management and reduces procedures after LSG.

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Conflict of interest

Authors M. Nedelcu, T. Manos, and A. Cotirlet have no conflicts of interest or financial ties to disclose. P. Noel has honorarium for speaking engagements Olympus, and Gore. M. Gagner has honorarium for speaking engagements from Ehicon Endosurgery, Covidien, Olympus, MID, Transenterix, Gore, and Boehringer Labs.

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Authors and Affiliations

  1. Digestive and Endocrine Surgery, University Hospital of Strasbourg, 1, Place de l’Hôpital, 67091, Strasbourg, France

    Marius Nedelcu

  2. Bouchard Clinic, Marseille, France

    Thierry Manos

  3. Moinesti Emergency Hospital, Moinesti, Romania

    Adrian Cotirlet

  4. Private Hospital La Casamance, Aubagne, France

    Patrick Noel

  5. Sacre Cœur Hospital, Montreal, Canada

    Michel Gagner

Authors
  1. Marius Nedelcu
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  2. Thierry Manos
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  3. Adrian Cotirlet
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  4. Patrick Noel
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  5. Michel Gagner
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Corresponding author

Correspondence to Marius Nedelcu.

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Nedelcu, M., Manos, T., Cotirlet, A. et al. Outcome of Leaks After Sleeve Gastrectomy Based on a New Algorithm Adressing Leak Size and Gastric Stenosis. OBES SURG 25, 559–563 (2015). https://doi.org/10.1007/s11695-014-1561-y

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  • DOI: https://doi.org/10.1007/s11695-014-1561-y

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