Treatment of Persistent Leaks After Laparoscopic Sleeve Gastrectomy with the Simultaneous Over-the-Scope Clip (OTSC) and Mega Stent Strategy.

Abstract

Persistent staple-line leak is a challenging complication after laparoscopic sleeve gastrectomy (LSG). The over-the-scope clip (OTSC) (Ovesco®, Tübingen, Germany) and the Mega stent (Taewoong medical, Seoul, South Korea) recently gained encouraging results in the management of early leaks. This is a retrospective series (n = 8) focused on the management of persistent leaks after LSG with the simultaneous OTSC/Mega stent strategy. Seven patients underwent primary LSG. The median time from LSG to OTSC/Mega stent treatment was 48.5days (range 28-63), and the median defect size was 9.5mm (range 7-12). The median time to clear liquid diet, hospital length of stay, and overall treatment time were 4days (range 2-5), 31days (range 26-57), and 47days (range 34-107), respectively. Overall success rate was 87.5%. Postoperative morbidity was 25%. The mean follow-up time was 18months (range 3-24) with no fistula recurrence.