Objectives: To evaluate surgical intervention versus stents insertion in management of staple line leaks after laparoscopic sleeve gastrectomy in morbidly obese patients. Patients and methods: Prospective randomized study including 30 hemodynamically stable patients presented early post sleeve leaks discovered by routine postoperative imaging or during follow up period. Patients recruited from El-Demerdash university hospital and El Zahraa university hospital during period January 2014 to December 2018. Patients were divided in two equal ratio groups: Endoscopy group: included 15 patients post sleeve leakage underwent stent insertion and Surgery group: included 15 patients post sleeve leakage underwent surgical management. Results: Mean interval between Initial surgery and leak in endoscopy group was 4.5±2.7 days with most common site of leak GE junction (80%). Mean interval between Initial surgery and leak in surgery group was 4.6±2.2 days; while most common site leak, GE junction (73.3%) with no statistical significance. Leak closure was achieved in 13 (86.66%) in endoscopy group and only 2 patients required conversion R en Y with closure of leak and leak control within 3.3±5.5 days. Average hospital stay was 8.3 ±4.4 days. Leak closure achieved in 7 (46.6%) 13 (86.66%) in surgery group, seven patients required conversion to R en Y either from the start or after failure of direct suturing to control spillage, while one patients died. interval between closure of leak and leak control was 5 ±4.3 days. With average hospital stay 8.3 ±4.4 days. There was no statistically significant association between type of management and outcomes (p =0.51). In contrary, there was statistically significant association between type of management and interval for leak control (p <0.001) and hospital stay (p=0.012). There was no statistically significant association between the site of leak in both groups (p=0.48). Conclusion: Stenting is a better choice for spillage patients who are essentially steady. It is less dangerous than surgical procedure.
Abd El Aziz, H., & Mahmoud, M. (2020). Comparative Study between Surgical Intervention and Endoscopic Stenting for Management of Leakage after Sleeve Gastrectomy. Ain Shams Journal of Surgery, 13(2), 100-105. doi: 10.21608/asjs.2020.195047
MLA
Heba Tharwat Abd El Aziz; Mahmoud Abdelbaky Mahmoud. "Comparative Study between Surgical Intervention and Endoscopic Stenting for Management of Leakage after Sleeve Gastrectomy". Ain Shams Journal of Surgery, 13, 2, 2020, 100-105. doi: 10.21608/asjs.2020.195047
HARVARD
Abd El Aziz, H., Mahmoud, M. (2020). 'Comparative Study between Surgical Intervention and Endoscopic Stenting for Management of Leakage after Sleeve Gastrectomy', Ain Shams Journal of Surgery, 13(2), pp. 100-105. doi: 10.21608/asjs.2020.195047
VANCOUVER
Abd El Aziz, H., Mahmoud, M. Comparative Study between Surgical Intervention and Endoscopic Stenting for Management of Leakage after Sleeve Gastrectomy. Ain Shams Journal of Surgery, 2020; 13(2): 100-105. doi: 10.21608/asjs.2020.195047