Endoscopic Vacuum Therapy for Staple Line Leaks after Sleeve Gastrectomy

Obes Surg. 2020 Apr;30(4):1310-1315. doi: 10.1007/s11695-019-04269-6.

Abstract

Purpose: Management of staple line leaks (SLL) after sleeve gastrectomy (SG) is challenging. The aim of this study was to evaluate the effectiveness of a novel endoscopic vacuum therapy (EVT) modality in the management of sleeve leaks.

Materials and methods: Eight patients were treated with EVT for SLL. Therapy data and outcome measures including duration of therapy, therapy success, and change of treatment strategy were collected and analyzed.

Results: During the study period, SLL occurred in 1.6% of patients who underwent SG. After 9.8 ± 8.6 days of EVT, 3.3 ± 2.2 endoscopies, and 19 ± 15.1 days of hospitalization, endoscopic treatment using EVT was successful in seven out of eight patients (87.5%).

Conclusions: EVT is an effective method for the management of staple line leaks after sleeve gastrectomy. The use of the intraluminal open-pore film drainage (OFD) could be considered as an advantageous modality of EVT, regarding placement and complications.

Keywords: Bariatric surgery; Complications management; Endoscopic vacuum therapy (EVT); Open-pore film drainage (OFD); Sleeve gastrectomy.

MeSH terms

  • Anastomotic Leak / etiology
  • Anastomotic Leak / surgery
  • Gastrectomy / adverse effects
  • Humans
  • Laparoscopy*
  • Negative-Pressure Wound Therapy*
  • Obesity, Morbid* / surgery
  • Surgical Stapling / adverse effects