Diagnosis and Management of Postoperative Complications After Sleeve Gastrectomy

Overview

Journal J Metab Bariatr Surg

Date 2023 Jan 23

PMID 36685085

Authors

Ji Yeon Park

Affiliations

Soon will be listed here.

Abstract

Sleeve gastrectomy (SG) has demonstrated excellent outcomes in terms of weight loss and resolution of obesity-related comorbidities as a single procedure. It has gained rapidly increasing popularity among bariatric surgeons and patients over the last two decades. This is due to its relative ease of use and less frequent morbidities related to the procedure. Even though the overall complication rate after SG is reported to be lower than conventional Roux-en-Y gastric bypass or biliopancreatic diversion, it still affects 1-10% of the patients undergoing SG, which is not negligible. Early postoperative complications that can occur within 30 days after SG include hemorrhage, leakage, sleeve stenosis, and reflux. Thromboembolic events are rare but can occur after surgery. Here, we review the incidence, diagnosis, and management of these early postoperative complications.

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References

Assalia A, Ilivitzki A, Ofer A, Suissa A, Manassa E, Khamaysi I . Management of gastric fistula complicating laparoscopic sleeve gastrectomy with biological glue in a combined percutaneous and endoscopic approach. Surg Obes Relat Dis. 2018; 14(8):1093-1098. DOI: 10.1016/j.soard.2018.04.009. View

AlSabah S, AlRuwaished M, Almazeedi S, Al Haddad E, Chouillard E . Portomesenteric Vein Thrombosis Post-Laparoscopic Sleeve Gastrectomy: Case Series and Literature Review. Obes Surg. 2017; 27(9):2360-2369. DOI: 10.1007/s11695-017-2637-2. View

Gagner M, Deitel M, Kalberer T, Erickson A, Crosby R . The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009. Surg Obes Relat Dis. 2009; 5(4):476-85. DOI: 10.1016/j.soard.2009.06.001. View

Gagner M, Deitel M, Erickson A, Crosby R . Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. Obes Surg. 2013; 23(12):2013-7. DOI: 10.1007/s11695-013-1040-x. View

Abou Rached A, Basile M, El Masri H . Gastric leaks post sleeve gastrectomy: review of its prevention and management. World J Gastroenterol. 2014; 20(38):13904-10. PMC: 4194572. DOI: 10.3748/wjg.v20.i38.13904. View

Alban E, Garcia C, Ospina L, Munevar H . Imaging after Bariatric Surgery: When Interpretation Is a Challenge, from Normal to Abnormal. Obes Surg. 2018; 28(9):2923-2931. DOI: 10.1007/s11695-018-3334-5. View

Sroka G, Milevski D, Shteinberg D, Mady H, Matter I . Minimizing Hemorrhagic Complications in Laparoscopic Sleeve Gastrectomy--a Randomized Controlled Trial. Obes Surg. 2015; 25(9):1577-83. DOI: 10.1007/s11695-015-1580-3. View

Giuliani A, Romano L, Marchese M, Necozione S, Cianca G, Schietroma M . Gastric leak after laparoscopic sleeve gastrectomy: management with endoscopic double pigtail drainage. A systematic review. Surg Obes Relat Dis. 2019; 15(8):1414-1419. DOI: 10.1016/j.soard.2019.03.019. View

Parikh M, Issa R, McCrillis A, Saunders J, Ude-Welcome A, Gagner M . Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2012; 257(2):231-7. DOI: 10.1097/SLA.0b013e31826cc714. View

10.

Aboueisha M, Freeman M, Allotey J, Evans L, Caposole M, Tatum D . Battle of the buttress: 5-year propensity-matched analysis of staple-line reinforcement techniques from the MBSAQIP database. Surg Endosc. 2022; 37(4):3090-3102. DOI: 10.1007/s00464-022-09452-y. View

11.

Karaman K, Aziret M, Bal A, Oter V, Ercan M, Birol Bostanci E . Porto-mesenteric venous thrombosis after laparoscopic sleeve gastrectomy: A case report and systematic review of the 104 cases. Obes Res Clin Pract. 2018; 12(3):317-325. DOI: 10.1016/j.orcp.2017.12.002. View

12.

Shoar S, Poliakin L, Khorgami Z, Rubenstein R, El-Matbouly M, Levin J . Efficacy and Safety of the Over-the-Scope Clip (OTSC) System in the Management of Leak and Fistula After Laparoscopic Sleeve Gastrectomy: a Systematic Review. Obes Surg. 2017; 27(9):2410-2418. DOI: 10.1007/s11695-017-2651-4. View

13.

Billmann F, Pfeiffer A, Sauer P, Billeter A, Rupp C, Koschny R . Endoscopic Stent Placement Can Successfully Treat Gastric Leak Following Laparoscopic Sleeve Gastrectomy If and Only If an Esophagoduodenal Megastent Is Used. Obes Surg. 2021; 32(1):64-73. PMC: 8752538. DOI: 10.1007/s11695-021-05467-x. View

14.

Musella M, Cantoni V, Green R, Acampa W, Velotti N, Maietta P . Efficacy of Postoperative Upper Gastrointestinal Series (UGI) and Computed Tomography (CT) Scan in Bariatric Surgery: a Meta-analysis on 7516 Patients. Obes Surg. 2018; 28(8):2396-2405. DOI: 10.1007/s11695-018-3172-5. View

15.

Donatelli G, Dumont J, Cereatti F, Ferretti S, Vergeau B, Tuszynski T . Treatment of Leaks Following Sleeve Gastrectomy by Endoscopic Internal Drainage (EID). Obes Surg. 2015; 25(7):1293-301. DOI: 10.1007/s11695-015-1675-x. View

16.

Siddique I, Alazmi W, Al-Sabah S . Endoscopic internal drainage by double pigtail stents in the management of laparoscopic sleeve gastrectomy leaks. Surg Obes Relat Dis. 2020; 16(7):831-838. DOI: 10.1016/j.soard.2020.03.028. View

17.

Deslauriers V, Beauchamp A, Garofalo F, Atlas H, Denis R, Garneau P . Endoscopic management of post-laparoscopic sleeve gastrectomy stenosis. Surg Endosc. 2017; 32(2):601-609. DOI: 10.1007/s00464-017-5709-4. View

18.

Johari Y, Catchlove W, Tse M, Shaw K, Paul E, Chen R . A 4-tier Protocolized Radiological Classification System for Leaks Following Sleeve Gastrectomy. Ann Surg. 2021; 275(2):e401-e409. DOI: 10.1097/SLA.0000000000003984. View

19.

Angrisani L, Santonicola A, Iovino P, Ramos A, Shikora S, Kow L . Bariatric Surgery Survey 2018: Similarities and Disparities Among the 5 IFSO Chapters. Obes Surg. 2021; 31(5):1937-1948. PMC: 7800839. DOI: 10.1007/s11695-020-05207-7. View

20.

Kumar S, Hamilton B, Wood S, Rogers S, Carter J, Lin M . Is laparoscopic sleeve gastrectomy safer than laparoscopic gastric bypass? a comparison of 30-day complications using the MBSAQIP data registry. Surg Obes Relat Dis. 2018; 14(3):264-269. DOI: 10.1016/j.soard.2017.12.011. View