Endoscopic Clipping for the Treatment of Sleeve Gastrectomy Leaks: It Works!

Ali Almontashery, MD, Yaser Dahlan, MD, Khalid Alshahrani, MD, Adel Bakhsh, MD. King Abdualaziz Medical City, Jeddah, Saudi Arabia

 

Background – The purpose of this study is to present our experience in the management of persistent staple line leaks post LSG using endoscopic clipping.

Methods – Four patients presented with clinical and radiological evidence of a leak post LSG. All Patients underwent a diagnostic exploration with oversewing of the staple line, wide local drainage, and insertion of a feeding jejunostomy tube. Four weeks post operatively upper GI studies showed a persistent leak at the esophagogastric junction. Upper GI endoscopy and clipping was then used to close the gastric leak.

Results – This approach achieved adequate control of the leak in 3 patients and failed in one patient due to anatomical difficulties. After negative radiological studies oral diet was commenced 3 days post clipping and the patients were successfully discharged home.

Conclusion – Endoscopic clipping is a safe and a feasible therapeutic option in the treatment of staple line leaks post LSG. Its value compared to the other treatment options for refractory leaks will need to be evaluated in a prospective comparative study.
 


Session Number: Poster – Poster Presentations
Program Number: P458
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