Image-guided percutaneous drainage vs. surgical repair of gastrointestinal anastomotic leaks: is there a difference in hospital course or hospitalization cost?

Burke, Lauren M. B.; Bashir, Mustafa R.; Gardner, Carly S.; Parsee, Arthur A.; Marin, Daniele; Vermess, David; Bhattacharya, Syamal D.; Thacker, Julie K.; Jaffe, Tracy A.

doi:10.1007/s00261-014-0265-z

Cited by 14 publications

(10 citation statements)

References 28 publications

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“…A successful interventional drainage significantly lowers mortality rate, comparing with medical treatment alone (74). Percutaneous drainage, is an effective therapy in patients with ALs who are hemodynamically stable and do not have signs of diffuse peritonitis, resulting in lower hospital costs and shorter hospital stays compared with surgical management.…”

Section: Nonoperative Interventionsmentioning

confidence: 99%

Management of anastomotic leakage after rectal surgery: a review article

Tsai¹,

Chen²

2019

J Gastrointest Oncol

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Anastomotic leaks (ALs) are associated with increased perioperative morbidity and mortality, prolonged length of stay, higher readmission rates, the potential need for further operative interventions, and unintended permanent stomas; resulting in increased hospital costs and resource use, and decreased quality of life. This review article is to present definition, diagnosis and management strategies for AL after rectal surgery.

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Section: Nonoperative Interventionsmentioning

confidence: 99%

Management of anastomotic leakage after rectal surgery: a review article

Tsai¹,

Chen²

2019

J Gastrointest Oncol

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“…CT is the preferred imaging modality for drainage of deeper intra-abdominal collections [7]. Compared with surgical management, gastrointestinal anastomotic leaks managed by percutaneous image-guided drainage are associated with lower hospital costs and shorter hospital stays [10]. Furthermore, the stomach and the liver may be traversed to allow treatment of an epigastric collection unreachable by other routes [11].…”

Section: Discussionmentioning

confidence: 99%

Percutaneous CT-Guided Drainage of Gastric Leaks Post-Sleeve Gastrectomy

Alharbi¹

2020

OJRad

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Objectives: The aim of this study was to assess the safety and efficacy of percutaneous CT-guided drainage of gastric leaks post sleeve gastrectomy. Methods: For this single-center retrospective study, we reviewed the clinical data of 78 patients (44 men and 34 women with an average age of 34.6 ± 10.5 years and a body mass index (BMI) of 45 kg/m 2 ± 3.2) that underwent percutaneous CT-guided drainage of gastric leaks due to sleeve gastrectomy from September 2011 to September 2018. The outcome measurements were technical and clinical success, complications, and the need for revisional surgery. Results: The technical success rate of drain insertion was 97.5% (76/78 patients). All of the patients (76/76 patients) exhibited early clinical and laboratory improvement, and no emergency surgery was required. However, six patients underwent revisional surgery after 3 -5 months for non-healing gastric leaks/fistulas. One patient had a major complication of active bleeding due to arterial injury; this was managed by transcatheter coil embolization. All patients underwent endoluminal stent placement and received antimicrobial therapy and nutritional support. Conclusion: Percutaneous CT-guided drainage of gastric leaks after sleeve gastrectomy is a safe, effective, and minimally invasive alternative to surgery. This technique is in line with other conservative measures (endoluminal stent placement, antimicrobial therapy, and nutritional support), which heal most gastric leaks due to sleeve gastrectomy and prevent the need for revisional surgery.

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“…Multiple studies in the surgical and radiological literature have documented the effectiveness of percutaneous drainage to treat post-operative localized intra-abdominal abscess [38][39][40][41]. Percutaneous drainage is the optimal means of treating post-operative localized intra-abdominal abscesses when there are no signs of generalized peritonitis.…”

Section: Managementmentioning

confidence: 99%

The challenge of post-operative peritonitis after gastrointestinal surgery

Sartelli

Griffiths

2015

Updates Surg

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Post-operative peritonitis (PP) is a life-threatening hospital-acquired intra-abdominal infection with high rates of mortality. Diffuse PP remains a challenge for surgeons. Prognosis and outcome of patients are directly related to early diagnosis and prompt intervention. The diagnosis of PP may be difficult because there are no specific clinical signs and laboratory tests to reject or confirm the diagnosis. Atypical clinical features may be responsible for a delay in reoperation. An early diagnosis and prompt treatment is crucial to prevent the development of organ failure and improve the outcome of the patients with PP. The cornerstones in the management of patients with PP are early hemodynamic support, prompt source control and adequate antimicrobial therapy.

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Image-guided percutaneous drainage vs. surgical repair of gastrointestinal anastomotic leaks: is there a difference in hospital course or hospitalization cost?

Abstract: Gastrointestinal anastomotic leaks managed by percutaneous drainage are associated with lower hospital cost and shorter hospital stays compared with surgical management.

Cited by 14 publications

References 28 publications

Management of anastomotic leakage after rectal surgery: a review article

Management of anastomotic leakage after rectal surgery: a review article

Percutaneous CT-Guided Drainage of Gastric Leaks Post-Sleeve Gastrectomy

The challenge of post-operative peritonitis after gastrointestinal surgery

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