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    Treatment of staple line leaks after laparoscopic sleeve gastrectomy with self-expandable metalic stents
    (Turkiye Klinikleri, 2016) Ece, İ.; Yılmaz, Hüseyin; Alptekin, Hüsnü; Acar, Fahrettin; Yormaz, S.; Çolak, B.; Şahin, Mustafa
    Objective: Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric procedure on weight loss and obesity-related comorbidities. The most important complication of LSG is the staple line leaks (SLL). This study aims to report the SLL rate and its management with self-expandable stent in a series of 422 LSGs. Material and Methods: A total of 422 patients underwent LSG from January 2010 to June 2015. A retrospective study was performed to the patients who were diagnosed as staple line leak at department of obesity surgery of a university hospital. The gastric resection was started from the antrum with a distance of 4-6 cm to the pilorus, by a 60mm staples. A 36F bougie was used to calibrate the gastric tube. The staple line was routinely reinforced with running sutures. The patients who developed SLL were treated endoscopically with self-expandable metalic stent (SEMS) placement. Results: The mean age of patients were 41.8 (29-55) years, and female/male ratio was 7/5. Mean body mass index of 44.1 kg/m2 in patients, one of the cases has a gastric banding history. SLL rate was 12/422 (2.8%). Leak area was near the gastroesophageal junction in all cases. SLL was treated with self-expandable metalic stents. All patients were received medical support, including parenteral nutrition and antibiotics. The stent treatment modalities were successful in all cases. Conclusion: SLL was the most common complication of LSG accounting for half of the overall complications. Self-expandable stents combined with antibiotics and parenteral nutrition are effective for SLL and should be proposed as first-line treatment in stable patients. © 2016 by Türkiye Klinikleri.