Management of Sleeve Gastrectomy Leaks with Endoluminal Vacuum Therapy

Steven G Leeds, MD, James S Burdick, MD. Baylor University Medical Center at Dallas

Introduction: Sleeve gastrectomy has become a popular weight loss procedure with great success, but is associated with staple line leak that can result in high morbidity and mortality. Current management options range from endoscopic stent placement to surgical intervention. Endoluminal vacuum (E-Vac) therapy has been recognized as a viable option for use in anastomotic leaks and perforations of the GI tract.

Methods: We present a case of a patient that has had several operations following a laparoscopic sleeve gastrectomy leak and is managed with E-Vac therapy.

Results: The patient’s E-Vac therapy started on postoperative day 17. She was treated with evaluations every 4 to 7 days. There was an appearance of healing early in her hospital course but this was complicated by a distal sleeve stricture and causing re-fistulization. She was managed with E-Vac therapy until closure a total of 65 days later.

Conclusion: E-Vac therapy is a safe and viable option for patients with staple line leak following LSG.

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