Management of Post-operative Leakage after Sleeve Gastrectomy (A Systematic Review)

Abstract

Abstract Background the prevalence of obesity and overweight have reached epidemic proportions in the last decades, with estimates by the World Health Organization (WHO) pointing that about 2 billion people are at least overweight worldwide. Aim of the Work to establish, through the available literature, what is the current management of leakage after sleeve gastrectomy in relation to each patient’s condition through the range of interventions available and their effectiveness. Materials and Methods the search is carried out using the electronic national library of medicine’s PubMed database plus manual reference checks of articles published on laparoscopic sleeve gastrectomy for morbid obesity and its complications focusing on post-operative leakage. Electronic results were screened by title to exclude duplicate studies. Articles were identified by keywords: “laparoscopic sleeve gastrectomy” “leakage after sleeve” “gastric leak” and “management of leakage” and will be limited to research papers of all designed on human patients in English languish. Articles with no focus on leakage after sleeve gastrectomy were excluded from eligibility in this review. Results through this study, it is found that: 1- Early detection and management are very important to control the leak. 2- The early unstable patient should be operated for lavage and drainage and re-suturing of leak site if the tissue still healthy. 3- Management of the leakage after LSG still non-standardized and there are multiple treatment options, so it is important to carefully choose the best treatment options for each patient. Conclusion early diagnosis and deciding the best treatment option is important to reach a complete resolution of the leak. From this study, we concluded that treatment of gastric leak after LSG mainly depend on three factors; time of the leak, clinical presentation of the patient and site of the leak.