Conservative Management of Anastomotic Leaks after 557 Open Gastric Bypasses

Abstract

The occurrence of an anastomotic leak is nearly 2% after gastric bypass. The majority of them can be managed medically, without the need for a reoperation, due to the fact that there is no acid production in the small gastric pouch and there is no intestinal reflux due to the long Roux loop.

The usefulness and costs of routine contrast studies after laparoscopic sleeve gastrectomy for detecting staple line leaks

“…8 In a 2012 systematic review of 29 studies involving 4888 patients, the authors reported leaks occurred in 0%-7% of LSG cases, with a higher leak rate observed in patients with a BMI above 50 than in those with a BMI below 50 (2.9% v. 2.2%). 11 Csendes and colleagues [12][13][14] reported that 3 types of leaks may develop after bariatric operations: 1) early leak, which appears 1-3 days after surgery and is usually secondary to technical surgical problems; 2) intermediate leaks, which appear 4-7 days after surgery; and 3) late leaks, which appear 8 or more days after surgery.…”

Endoscopic stenting for laparoscopic sleeve gastrectomy leaks

“…), or late (after 8 days p.o. ), and suturing of the leaks did not provide success in case series in either early or intermediate term (9,11).…”

Conservative management of leakage after laparoscopic sleeve gastrectomy

“…Subclinical leakages are defined as type 1 and clinical leakages are type 2. Csendes et al [8] defined postoperative leakages early if occurred on one to three days, intermediate if occurred in four to seven days and late for those manifested after eight days. Our case was an intermediate leakage that occurred on postoperative day five.…”