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Treatment of Gastric Leaks with Coated Self-Expanding Stents after Sleeve Gastrectomy

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Background

Duodenal switch (DS) is one of the most effective techniques for the treatment of morbid obesity and its co-morbidities, with mortality rate <1%, but with 9.4% morbidity rates (6.5% due to leaks). In our experience, leaks of the staple-line after sleeve gastrectomy (SG) are the most frequent sites of fistula formation and conservative treatment usually takes a long time.We present our experience in the treatment of gastric leaks with coated self-expandable stents (CSES).

Methods

6 patients had gastric leaks at the gastroesophageal (GE) junction after SG or DS. One patient had a symptomatic gastro-bronchial fistula. Stents were placed by the interventional radiologist under fluoroscopic control and removed endoscopically. In one case, we used an uncoated Wallstent. In two patients, percutaneous microcoil embolization of the fistula was added.

Results

The patient treated with the Wallstent required a total gastrectomy 6 months after placement of the uncovered stent. In the other 5 patients, coated stents were successfully removed and the gastric leaks completely sealed.

Conclusions

CSES are proposed as an alternative therapeutic option for the management of GE junction leaks in bariatric surgery with good results in terms of morbidity and survival.

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Authors and Affiliations

  1. General Surgery Service and Interventional Radiology, Virgen de los Lirios Hospital, Alcoy, Alicante, Spain

    Carlos Serra MD, PhD, Aniceto Baltasar MD, Luis Andreo MD, Nieves Pérez MD, Rafael Bou MD, Marcelo Bengochea MD & Juan José Chisbert

  2. Servicio de Cirugía General, Hospital Virgen de los Lirios, Polígono de Caramanxel s/n, 03804, Alcoy, Alicante, Spain

    Carlos Serra MD, PhD

Authors
  1. Carlos Serra MD, PhD
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  2. Aniceto Baltasar MD
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  3. Luis Andreo MD
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  4. Nieves Pérez MD
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  5. Rafael Bou MD
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  6. Marcelo Bengochea MD
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  7. Juan José Chisbert
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Corresponding author

Correspondence to Carlos Serra MD, PhD.

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Serra, C., Baltasar, A., Andreo, L. et al. Treatment of Gastric Leaks with Coated Self-Expanding Stents after Sleeve Gastrectomy. OBES SURG 17, 866–872 (2007). https://doi.org/10.1007/s11695-007-9161-8

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  • DOI: https://doi.org/10.1007/s11695-007-9161-8

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