Abstract
Laparoscopic sleeve gastrectomy has become a popular procedure for the surgical management of morbid obesity [ 1 Aggarwal S. Kini S.U. Herron D.M. Laparoscopic sleeve gastrectomy for morbid obesity: a review. Surg Obes Relat Dis. 2007; 3: 189-194 Abstract Full Text Full Text PDF PubMed Scopus (67) Google Scholar , 2 Márquez M.F. Ayza M.F. Lozano R.B. Morales-Mdel M. Díez J.M. Poujoulet R.B. Gastric leak after laparoscopic sleeve gastrectomy. Obes Surg. 2010; 20: 1306-1311 Crossref PubMed Scopus (116) Google Scholar ]. However, postoperative gastric leak after this procedure is a serious complication. The reported incidence of leak has varied from 0% to 5% [ 2 Márquez M.F. Ayza M.F. Lozano R.B. Morales-Mdel M. Díez J.M. Poujoulet R.B. Gastric leak after laparoscopic sleeve gastrectomy. Obes Surg. 2010; 20: 1306-1311 Crossref PubMed Scopus (116) Google Scholar , 3 Bellanger D.E. Greenway F.L. Laparoscopic sleeve gastrectomy, 529 cases without a leak—short term results and technical considerations. Obes Surg. 2011; 21: 146-150 Crossref PubMed Scopus (128) Google Scholar , 4 Burgos A.M. Braghetto I. Csendes A. et al. Gastric leak after laparoscopic-sleeve gastrectomy for obesity. Obes Surg. 2009; 19: 1672-1677 Crossref PubMed Scopus (193) Google Scholar , 5 Casella G. Soricelli E. Rizzello M. et al. Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obes Surg. 2009; 19: 821-826 Crossref PubMed Scopus (168) Google Scholar , 6 Tan J.T. Kariyawasam S. Wijeratne T. Chandraratna H.S. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010; 20: 403-409 Crossref PubMed Scopus (114) Google Scholar ]. The leak usually occurs through the upper part of the staple line near the gastroesophageal junction [ [4] Burgos A.M. Braghetto I. Csendes A. et al. Gastric leak after laparoscopic-sleeve gastrectomy for obesity. Obes Surg. 2009; 19: 1672-1677 Crossref PubMed Scopus (193) Google Scholar ]. It is a source of major morbidity and can be fatal. Intraoperative tests such as the methylene blue dye test, air leak test and endoscopy are used variably to diagnose staple line disruption. These tests are important when their findings are positive. A negative test, however, does not eliminate the possibility of leak in the postoperative period [ [5] Casella G. Soricelli E. Rizzello M. et al. Nonsurgical treatment of staple line leaks after laparoscopic sleeve gastrectomy. Obes Surg. 2009; 19: 821-826 Crossref PubMed Scopus (168) Google Scholar ]. Hence, the routine practice of intraoperative leak test is widely debated.
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