ArticleObesity surgery2016
Endoscopic Therapy for Treatment of Staple Line Leaks Post-Laparoscopic Sleeve Gastrectomy (LSG): Experience from a Large Bariatric Surgery Centre in New Zealand.
Article in Obesity surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 5 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
27 citing papers in PubMed, 5 syntheses or guidelines pooled it, 62 citations in OpenAlex.
- Endoscopic Treatment of Staple-Line Leaks After Sleeve Gastrectomy in Patients with Obesity: Which One is the Best Option, if Any? A Systematic Review with Meta-Analysis and Meta-regression.Obesity surgery · 2025Pooled it
- Endoscopic closure techniques of bariatric surgery complications: a meta-analysis.Surgical endoscopy · 2024Pooled it
- Endoscopic management of leaks and fistulas after bariatric surgery: a systematic review and meta-analysis.Surgical endoscopy · 2021Pooled it
- Customized bariatric stents for sleeve gastrectomy leak: are they superior to conventional esophageal stents? A systematic review and proportion meta-analysis.Surgical endoscopy · 2021Pooled it
- Management of Staple Line Leaks Following Sleeve Gastrectomy-a Systematic Review.Obesity surgery · 2019Pooled it
- Comparison Between Stable Line Reinforcement by Barbed Suture and Non-reinforcement in Sleeve Gastrectomy: a Randomized Prospective Controlled Study.Obesity surgery · 2018Trial
- Fully Covered Self-Expandable Metal Stents for the Treatment of Leak After Oncologic Gastroesophageal Surgery: A Cohort Study.Reviews on recent clinical trials · 2025Article
- Rare Complications Following Laparoscopic Sleeve Gastrectomy.Journal of clinical medicine · 2024Review
- Endoscopic stent placement for the management of gastro-pleural and gastro-cutaneous fistula post laparoscopic sleeve gastrectomy: a case report.Journal of medical case reports · 2023Article
- Endoscopic treatment of upper gastrointestinal postsurgical leaks: a narrative review.Clinical endoscopy · 2023Review
- The Use of Esophageal Stents in the Management of Postoperative Fistulas-Current Status, Clinical Outcomes and Perspectives-Review.Life (Basel, Switzerland) · 2023Review
- Technical Review on Endoscopic Treatment Devices for Management of Upper Gastrointestinal Postsurgical Leaks.Gastroenterology research and practice · 2023Review
- Endoscopic Stent Placement Can Successfully Treat Gastric Leak Following Laparoscopic Sleeve Gastrectomy If and Only If an Esophagoduodenal Megastent Is Used.Obesity surgery · 2022Article
- Nonoperative Management of Leaks After Laparoscopic Sleeve Gastrectomy With Endoscopic Stents in a Tertiary Referral Center.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2022Article
- Endoscopic Management of Staple Line Leak after Bariatric Surgery: Surgeon's Perspective.Clinical endoscopy · 2021Article
- Gastric Fistula After Sleeve Gastrectomy: Clinical Features and Treatment Options.Obesity surgery · 2021Article
- Endoscopic management of post-surgical GI wall defects with the overstitch endosuturing system: a single-center experience.Surgical endoscopy · 2020Observational
- Endoscopic treatment of early leaks and strictures after laparoscopic one anastomosis gastric bypass.BMC surgery · 2020Article
- Endoscopic septotomy as a treatment for leaks after sleeve gastrectomy: Meeting presentations: Digestive Disease Week 2019.Endoscopy international open · 2020Article
- Long-term outcomes following endoscopic stenting in the management of leaks after foregut and bariatric surgery.Surgical endoscopy · 2019Article
Corrections and comments
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Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundLaparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedures for treatment of morbid obesity. Despite its popularity, it is not without risks, the most serious of which is the staple line leak. Staple line leaks are difficult to manage and require significant resources in the form of surgical, radiological and endoscopic interventions; long hospital and intensive care stay and significant morbidity. International experience is slowly emerging, but there are still no clear guidelines regarding optimal management of leaks. This study aims to describe the experience of endoscopic management of these leaks by the authors and the development of a customised stent for this condition.
methodsMiddlemore Hospital is the largest bariatric surgery centre in New Zealand. Since June 2007, a total of 21 patients have received endotherapy for post-LSG leak management. Treatment included the deployment of primary self-expanding metal stents (SEMS) across the leak site, combined with complementary endoscopic modalities. Persistent leaks were treated with follow-up stenting. This study aimed to evaluate the effectiveness of post-LSG staple line leak management at Middlemore Hospital.
resultsA total of 20/21 (95 %) patients now have resolved leaks following a mean of 75 days of treatment (median 47, range 9-187). The mean number of endoscopic procedures required was five. Inpatient stay and average duration till leak resolution has been notably reduced since the addition of customised stents. Clinically significant stent migration occurred in 19 % of primary stents.
conclusionThe use of SEMS in conjunction with complementary endotherapy has shown to be both safe and effective in treating sleeve leaks; however, migration is the limiting factor for optimal management. Recent improvements in stent design, such as the one proposed in this paper, show promise in addressing this problem. Earlier use of SEMS seems to reduce the time till closure as well as the total hospital stay, as is apparent from our data.
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