Gastric Staple Line Leaks After Laparoscopic Sleeve Gastrectomy, Endoscopic Stent Insertion Versus Surgical Intervention Treatment

Abstract

Background: Endoscopic stenting (ES) provides comfortable management of Gastric staple line leaks (GSLL); it is less invasive than conventional surgery. Objective: The aim of the current study is to assess the efficacy of endoscopic stenting versus surgical intervention in treating gastric stable line leakage following laparoscopic sleeve gastrectomy (LSG). Patients and methods: In Helwan University Hospitals, 40 patients had GSLL post LSG between January 2018 and August 2022. We proceeded our management to either: ES placement (Group A) or surgical management (SM) (Group B), 2o in each group. Results: Regarding postoperative complications, there is a significant statistical difference regarding wound infection, but no significant difference regarding chest infection, DVT, subphrenic abscess, severe vomiting, GERD, failure of Roux-en-Y, stent migration, or stricture. There is a non-significant association between the type of participant management and the outcomes of the intervention. However, there was a statistically significant association between the type of participant management and the interval period between GSLL closure and its control (P value <0.001) and patients' hospital stay (P= 0.001), as participants who underwent ES spent less time in the hospital. Conclusion: Management of post-LSG leakage with ES is advocated as it is a minimally invasive technique that effectively manages GSLL and has a comparable control success rate to definitive surgical treatment with a shorter hospital stay, early return of function, fewer complications, and a well-tolerable safety profile. In stable patients, ES should be recommended as first-line therapy.