ArticleObesity surgery2019
Endoscopic Internal Drainage Coupled to Prompt External Drainage Mobilization Is an Effective Approach for the Treatment of Complicated Cases of Sleeve Gastrectomy.
Article in Obesity surgery, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 14 papers, 1 of them a synthesis that pooled it.
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Who cites it
14 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Vacuum Therapy and Internal Drainage as the First-Line Endoscopic Treatment for Post-Bariatric Leaks: A Systematic Review and Meta-Analysis.Visceral medicine · 2022Pooled it
- Endoscopic Management of Post-Bariatric Surgery Complications: Diagnostic Work-Up and Innovative Approaches for Leak, Fistula, and Stricture Management.Diagnostics (Basel, Switzerland) · 2026Review
- Multimodal Endoscopic Management of Fistula after Sleeve Gastrectomy Involving a Novel Esophageal Stent.GE Portuguese journal of gastroenterology · 2025Article
- Choosing the best endoscopic approach for post-bariatric surgical leaks and fistulas: Basic principles and recommendations.World journal of gastroenterology · 2023Review
- Article
- Nutritional Support and Duration of Drainage Recommendations for Endoscopic Internal Drainage: Review of the Literature and Initial Experience.Obesity surgery · 2022Review
- Endoscopic Negative Pressure Therapy (ENPT) Is Superior to Stent Therapy for Staple Line Leak After Sleeve Gastrectomy: a Single-Center Cohort Study.Obesity surgery · 2021Article
- Role of Primary Use of Mega Stents Alone and Combined with Other Endoscopic Procedures for Early Leak and Stenosis After Bariatric Surgery, Single-Institution Experience.Obesity surgery · 2021Article
- Revisional Surgeries of Laparoscopic Sleeve Gastrectomy.Diabetes, metabolic syndrome and obesity : targets and therapy · 2021Review
- Endoscopic management of anastomotic leak after esophageal or gastric resection for malignancy: a multicenter experience.Therapeutic advances in gastroenterology · 2021Article
- Percutaneous embolization for a subacute gastric fistula following laparoscopic sleeve gastrectomy: a case report and literature review.BMC surgery · 2020Review
- Endoscopic Management of Clinically Severe Obesity: Primary and Secondary Therapeutic Procedures.Current obesity reports · 2020Review
- Endoscopic Ultrasound (EUS)-Guided Drainage of a Postsleeve Gastrectomy Subphrenic Collection Using a Lumen Apposition Stent.Obesity surgery · 2020Article
- Endoscopic Vacuum Therapy for Staple Line Leaks after Sleeve Gastrectomy.Obesity surgery · 2020Article
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Authors and funding
6 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionDespite advances in treating gastric staple line leaks after bariatric surgical procedures, chronic leaks have been reported. Failure of their treatment frequently leads to radical surgery. We aimed to describe a strategy for preventing occurrence of chronic gastric leaks after complicated sleeve gastrectomy in patients necessitating relaparoscopy and external drainage as a first step of gastric leak management.
methodsData from 14 consecutive patients admitted for gastric leak after laparoscopic sleeve gastrectomy were prospectively collected and retrospectively analyzed. Patients included underwent relaparoscopy and external drainage as first step of management.
resultsMedian time to gastric leak detection was 4 days. Emergency relaparoscopy allowed peritoneal lavage and external drainage placement next to the leak. Median time between surgery and endoscopic internal drainage (EID) was 4 days. Progressive external drainage mobilization started after 2 days. Control endoscopy was performed every 4 weeks until healing. A median interval of 112 days was necessary before healing in 13 patients. Thirteen patients (92.8%) had no gastric leak recurrence at 1 year. In one patient, EID was considerably delayed and external drainage mobilization prolonged, leading to chronic gastric leak and total gastrectomy after 18 months.
conclusionThis study reports for the first time a well-standardized protocol of early EID after relaparoscopy coupled to rapid external drainage removal for effectively treating complicated cases of sleeve gastrectomy. Bariatric surgeons should be aware of such therapeutic strategies and include them in their arsenal against postoperative gastric staple line leaks in severely obese patients.
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