Endoscopic Management of Staple Line Leak after Bariatric Surgery: Surgeon’s Perspective
| Autor: | Chung, Yoona, Park, Dae Geun, Kim, Yong Jin |
|---|---|
| Rok vydání: | 2021 |
| Předmět: |
obesity
medicine.medical_specialty medicine.medical_treatment Medicine (miscellaneous) RC799-869 Endoscopic management 03 medical and health sciences Hemodynamically stable 0302 clinical medicine medicine Radiology Nuclear Medicine and imaging Internal medicine morbid Primary procedure Laparoscopic sleeve gastrectomy business.industry Optimal treatment Gastroenterology Clipping (medicine) Diseases of the digestive system. Gastroenterology Tissue sealant RC31-1245 Surgery Focused Review Series: Endoscopic Management of Postoperative Gastrointestinal Complication: What’s New? stents 030220 oncology & carcinogenesis Staple line surgical stapling 030211 gastroenterology & hepatology business drainage |
| Zdroj: | Clinical Endoscopy, Vol 54, Iss 6, Pp 805-809 (2021) Clinical Endoscopy |
| ISSN: | 2234-2443 2234-2400 |
| Popis: | Laparoscopic sleeve gastrectomy (LSG) has become a standalone primary procedure as a bariatric metabolic surgery since the early 2000s. The overall complication rate of LSG is reported to range from 2% to 15%. Staple line leakage (SLL) remains a major adverse event and occurs in approximately 1–6% of patients. Choosing the optimal treatment modality is a complex process. Clinicians must understand that nutritional support and drainage of fluid collection are essential for initial management. Conservative endoscopic management and sufficient drainage can resolve approximately 70% of SLLs. Endoscopic management of bariatric complications has been rapidly evolving in recent years and can be considered in all patients who are hemodynamically stable. We will review the available endoscopic management techniques, including stent placement (self-expanding stents and bariatric-specific stents), clipping, tissue sealant application, and internal drainage (double-pigtail stents [DPS] placement, endoscopic vacuum therapy, and septotomy). Stent placement remains the mainstream treatment for SLLs. However, healing with stents requires multiple sessions/stents and a long course of recovery. Endoscopic internal drainage is gaining popularity and has the potential to be a superior method. The importance of early intervention and combined endoscopic methods should be recognized. |
| Databáze: | OpenAIRE |
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