ArticleUpdates in surgery2026
Preoperative serum protein concentration as a predictor of staple-line leak after sleeve gastrectomy: a retrospective cohort study.
Article in Updates in surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundStaple-line leak is the most frequent post-operative complication after sleeve gastrectomy (SG). Low serum protein concentration (SPC), a condition associated with malnutrition, is common among people with obesity. Whether low SPC represents a risk factor for staple-line leak has been actually not extensively investigated. The objective of this study is to assess the relationship between low SPC and staple-line leak in patients undergoing SG.
methodsA prospectively collected database was queried for consecutive patients who underwent SG between January 1st 2010 and December 31st 2022 at a single institution. PRIMARY ENDPOINT: to investigate the relationship between low pre-operative SPC and staple-line leak occurred within 30 days. Secondary endpoint: to investigate other patients' and surgeon's related risk factors for leak.
results1669 patients were included in the study. Staple-line leak occurred in 53 patients (3.2%). Patients with staple-line leak had a significantly lower SPC than patients with a normal post-operative course (median 6.8 vs. 7.1 g/L; p < 0.001). High values of SPC significantly reduced the risk of leak (OR 0.20; 95% CI 0.09-0.45; p = 0.001). Major intraoperative bleeding and need of blood transfusions were significantly associated with a higher rate of leak (OR 3,58, 95% CI 1,45-8,86; p = 0,006; OR 9,79, 95% CI 3,66-26,22; p < 0,001) at a multivariable analysis.
conclusionThe occurrence of staple-line leak after SG is directly related to pre-operative low SPC, an index of malnutrition. Nutritional assessment and optimization of protein intake could potentially reduce the rate of leak.
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