Laparoscopic Conversion of Sleeve Gastrectomy to Roux-En-Y Gastric Bypass for Proximal Gastric Leak

Rena Moon, MD, Andre Teixeira, MD, Muhammad Jawad, MD, FACS

Department of Bariatric Surgery, Orlando Regional Medical Center, Orlando, Florida, USA

34 y/o F s/p LSG 3 months ago for morbid obesity. Presented to the ER with complaints of left shoulder pain and fever. Initial UGI showed a sleeve leak. Placed on abx and TPN. IR consulted for percutaneous drain placement.

Materials and Methods
Initial treatment was started by placing the patient on TPN and placing sleeve stent. Kept npo for 3 wks. Pt was admitted several times back to the hospital due to severe nausea, emesis and dehydration. Discussed with the patient all the possibility that included surgical intervention by converting a high pressure system sleeve gastrectomy to a low pressure system RYGB.

Postoperatively the patient did well, UGI done on POD #2 that was negative for any leaks. Discharged home on full liquid diet.

The most difficult complication to treat from a LSG is the leak. Due to the nature of a high pressure system, it’s very difficult for a leak to close. Some centers have converted sleeve gastrectomies to esophagojejunostomy by performing a gastrectomy of the sleeve. We have proposed to make a high pressure system into a low pressure system.

Session: Video ChannelDay 3

Program Number: V102

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