Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?

Introduction: Despite the unanimous acknowledgement of the laparoscopic sleeve gastrectomy (LSG) worldwide, the leak remains its deficiency. For the last decade, the surgical treatment was practically considered mandatory for almost any collection following LSG. The aim of this study is to evaluate...

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Authors: Nedelcu, Marius, Manos, Thierry, Noel, Patrick, Danan, Marc, Zulian, Viola, Vilallonga, Ramon|||0000-0001-9333-2765, Nedelcu, Anamaria, Carandina, Sergio|||0000-0003-0651-5606
Format: article
Publication Date:2023
Country:España
Institution:Universitat Autònoma de Barcelona
Repository:Dipòsit Digital de Documents de la UAB
Language:English
OAI Identifier:oai:ddd.uab.cat:272452
Online Access:https://ddd.uab.cat/record/272452
https://dx.doi.org/urn:doi:10.3390/jcm12041376
Access Level:Open access
Keyword:Sleeve gastrectomy
Endoscopy
Surgical drainage
Double pigtail
Septotomy
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spelling Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?Nedelcu, MariusManos, ThierryNoel, PatrickDanan, MarcZulian, ViolaVilallonga, Ramon|||0000-0001-9333-2765Nedelcu, AnamariaCarandina, Sergio|||0000-0003-0651-5606Sleeve gastrectomyEndoscopySurgical drainageDouble pigtailSeptotomyIntroduction: Despite the unanimous acknowledgement of the laparoscopic sleeve gastrectomy (LSG) worldwide, the leak remains its deficiency. For the last decade, the surgical treatment was practically considered mandatory for almost any collection following LSG. The aim of this study is to evaluate the need for surgical drainage for leak following LSG. Methods: All consecutive patients having gone through LSG from January 2017 to December 2020 were enrolled in our study. Once the demographic data and the leak history were registered, we analyzed the outcome of the surgical or endoscopic drainage, the characteristics of the endoscopic treatment, and the evolution to complete healing. Results: A total of 1249 patients underwent LSG and the leak occurred in 11 cases (0.9%). There were 10 women with a mean age of 47.8 years (27-63). The surgical drainage was performed for three patients and the rest of the eight patients underwent primary endoscopic treatment. The endoscopic treatment was represented with pigtails for seven cases and septotomy with balloon dilation for four cases. In two out of these four cases, the septotomy was anticipated by the use of a nasocavitary drain for 2 weeks. The average number of endoscopic procedures was 3.2 (range 2-6). The leaks achieved complete healing after an average duration of 4.8 months (range 1-9 months). No mortality was recorded for a leak. Conclusions: The treatment of the gastric leak must be tailored to each patient. Although there is still no consensus for the endoscopic drainage of leaks after LSG, the surgical approach can be avoided in up to 72%. The benefits of pigtails and nasocavitary drains followed by endoscopic septotomy are undeniable, and they should be included in the armamentarium of any bariatric center. 22023-01-0120232023-01-01Articlehttp://purl.org/coar/resource_type/c_6501VoRhttp://purl.org/coar/version/c_970fb48d4fbd8a85info:eu-repo/semantics/articleapplication/pdfhttps://ddd.uab.cat/record/272452https://dx.doi.org/urn:doi:10.3390/jcm12041376reponame:Dipòsit Digital de Documents de la UABinstname:Universitat Autònoma de BarcelonaInglésengopen accesshttp://purl.org/coar/access_right/c_abf2Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.https://creativecommons.org/licenses/by/4.0/info:eu-repo/semantics/openAccessoai:ddd.uab.cat:2724522026-06-06T12:50:31Z
dc.title.none.fl_str_mv Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
title Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
spellingShingle Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
Nedelcu, Marius
Sleeve gastrectomy
Endoscopy
Surgical drainage
Double pigtail
Septotomy
title_short Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
title_full Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
title_fullStr Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
title_full_unstemmed Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
title_sort Is the Surgical Drainage Mandatory for Leak after Sleeve Gastrectomy?
dc.creator.none.fl_str_mv Nedelcu, Marius
Manos, Thierry
Noel, Patrick
Danan, Marc
Zulian, Viola
Vilallonga, Ramon|||0000-0001-9333-2765
Nedelcu, Anamaria
Carandina, Sergio|||0000-0003-0651-5606
author Nedelcu, Marius
author_facet Nedelcu, Marius
Manos, Thierry
Noel, Patrick
Danan, Marc
Zulian, Viola
Vilallonga, Ramon|||0000-0001-9333-2765
Nedelcu, Anamaria
Carandina, Sergio|||0000-0003-0651-5606
author_role author
author2 Manos, Thierry
Noel, Patrick
Danan, Marc
Zulian, Viola
Vilallonga, Ramon|||0000-0001-9333-2765
Nedelcu, Anamaria
Carandina, Sergio|||0000-0003-0651-5606
author2_role author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Sleeve gastrectomy
Endoscopy
Surgical drainage
Double pigtail
Septotomy
topic Sleeve gastrectomy
Endoscopy
Surgical drainage
Double pigtail
Septotomy
description Introduction: Despite the unanimous acknowledgement of the laparoscopic sleeve gastrectomy (LSG) worldwide, the leak remains its deficiency. For the last decade, the surgical treatment was practically considered mandatory for almost any collection following LSG. The aim of this study is to evaluate the need for surgical drainage for leak following LSG. Methods: All consecutive patients having gone through LSG from January 2017 to December 2020 were enrolled in our study. Once the demographic data and the leak history were registered, we analyzed the outcome of the surgical or endoscopic drainage, the characteristics of the endoscopic treatment, and the evolution to complete healing. Results: A total of 1249 patients underwent LSG and the leak occurred in 11 cases (0.9%). There were 10 women with a mean age of 47.8 years (27-63). The surgical drainage was performed for three patients and the rest of the eight patients underwent primary endoscopic treatment. The endoscopic treatment was represented with pigtails for seven cases and septotomy with balloon dilation for four cases. In two out of these four cases, the septotomy was anticipated by the use of a nasocavitary drain for 2 weeks. The average number of endoscopic procedures was 3.2 (range 2-6). The leaks achieved complete healing after an average duration of 4.8 months (range 1-9 months). No mortality was recorded for a leak. Conclusions: The treatment of the gastric leak must be tailored to each patient. Although there is still no consensus for the endoscopic drainage of leaks after LSG, the surgical approach can be avoided in up to 72%. The benefits of pigtails and nasocavitary drains followed by endoscopic septotomy are undeniable, and they should be included in the armamentarium of any bariatric center.
publishDate 2023
dc.date.none.fl_str_mv 2
2023-01-01
2023
2023-01-01
dc.type.none.fl_str_mv Article
http://purl.org/coar/resource_type/c_6501
VoR
http://purl.org/coar/version/c_970fb48d4fbd8a85
dc.type.openaire.fl_str_mv info:eu-repo/semantics/article
format article
dc.identifier.none.fl_str_mv https://ddd.uab.cat/record/272452
https://dx.doi.org/urn:doi:10.3390/jcm12041376
url https://ddd.uab.cat/record/272452
https://dx.doi.org/urn:doi:10.3390/jcm12041376
dc.language.none.fl_str_mv Inglés
eng
language_invalid_str_mv Inglés
language eng
dc.rights.none.fl_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
dc.rights.openaire.fl_str_mv info:eu-repo/semantics/openAccess
rights_invalid_str_mv open access
http://purl.org/coar/access_right/c_abf2
https://creativecommons.org/licenses/by/4.0/
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.source.none.fl_str_mv reponame:Dipòsit Digital de Documents de la UAB
instname:Universitat Autònoma de Barcelona
instname_str Universitat Autònoma de Barcelona
reponame_str Dipòsit Digital de Documents de la UAB
collection Dipòsit Digital de Documents de la UAB
repository.name.fl_str_mv
repository.mail.fl_str_mv
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