ArticleObesity surgery2020
Malignant Leakage After Sleeve Gastrectomy: Endoscopic and Surgical Approach.
Article in Obesity surgery, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers, 1 of them a synthesis that pooled it.
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Who cites it
13 citing papers in PubMed, 1 synthesis or guideline pooled it, 18 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
- Modified gastric peroral endoscopic myotomy for helical stenosis after sleeve gastrectomy.VideoGIE : an official video journal of the American Society for Gastrointestinal Endoscopy · 2026Review
- Comparison of fibrin glue posterior fixation and omentopexy in laparoscopic sleeve gastrectomy: a propensity score-matched analysis.Updates in surgery · 2026Article
- Staple line leakage after laparoscopic sleeve gastrectomy in Japan: a nationwide survey.Surgery today · 2025Article
- Management of Gastric Leak after Sleeve Gastrectomy: A 13-year Experience in a Tertiary Referral Center.Obesity surgery · 2025Article
- Complications of Metabolic and Bariatric Surgery for the Gastroenterologist: A Comprehensive Review.Gastroenterology & hepatology · 2025Article
- Metabolic and Bariatric Surgeon Criteria-An International Experts' Consensus.Obesity surgery · 2024Article
- Efficacy of Omentopexy on Complications of Laparoscopic Sleeve Gastrectomy.Obesity surgery · 2024Article
- New Endoscopic Devices and Techniques for the Management of Post-Sleeve Gastrectomy Fistula and Gastric Band Migration.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
- GASTRIC TWIST AFTER SLEEVE GASTRECTOMY: A PROPOSAL FOR ENDOSCOPIC CLASSIFICATION.Arquivos brasileiros de cirurgia digestiva : ABCD = Brazilian archives of digestive surgery · 2022Article
- Endoscopic Evaluation and Management of Late Complications After Bariatric Surgery: a Narrative Review.Obesity surgery · 2021Review
- Gastro-Pleural Fistula Following Laparoscopic Sleeve Gastrectomy Masquerading as Loculated Empyema Thoracis: a Diagnostic Dilemma.Obesity surgery · 2020Article
Corrections and comments
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Authors and funding
10 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGastric leak occurs after sleeve gastrectomy (SG) in 2% of cases. Most staple-line disruptions (SLD) can be successfully treated with first-line endoscopic procedures. Less favorable situations may lead to more complex therapeutic strategies, like conversion to Roux-en-Y gastric bypass (RYGBP). The aim of our study is to predict the factors of endoscopic treatment failure and to assess the safety of conversion to RYGBP.
methodsWe included all patients treated in two centers of academic excellence (n = 100) between 2013 and 2017 who had a malignant SLD after SG. A "malignant" leakage met one of the following poor prognosis criteria suggested in the literature: unsuccessfully treated by the first-line endoscopic treatment; generalized peritonitis; anatomical anomalies; gastro-cutaneous or gastro-pleural fistula (GCF/GPF); or chronic leaks (> 4 weeks).
resultsNo deaths occurred during the follow-up (20 ± 12 months). The endoscopy reported an anatomically abnormal gastric tube in 35 (35%) patients (stenosis [n = 21 (21%)], twist [n = 9 (9%)], or both [n = 5 (5%)]). We could maintain the SG in place in 92% of cases without stenosis, twist, or GCF/GPF. Conversion to RYGBP due to leakage was necessary in 37 (37%) patients. Stenosis, twist, or GCF/GPF significantly prevented healing in multivariate analysis (respectively: p = 0.020, OR = 0.17, and p < 0.001, OR = 0.07-logistic regression).
conclusionEndoscopy is the treatment of choice for the management of chronic leaks after SG. The association of anatomical anomalies and GCF/GPF should lead to consideration of conversion to RYGBP.
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