Our Summary

This study looks at a common weight loss surgery, laparoscopic sleeve gastrectomy, and how to manage one of its potential complications: leaks along the line where the stomach was stapled. This complication is rare but can be serious and hard to treat.

The researchers looked back at cases from a clinic that specializes in this surgery over a ten-year period. They found ten cases where this leak occurred, which is less than 1% of all patients who had the surgery at that clinic during that time.

Patients usually started showing symptoms almost a month after the operation. All were diagnosed using a type of scan called a computed tomography. Treatment varied per patient: three had a second operation to wash out and drain the leak, and six had a procedure using a scope to either put in a stent or clip the leak. Most patients needed more than one of these treatments, averaging 2.4 treatments per person. It took an average of 48.2 days for the leak to fully heal.

The researchers concluded that treating these leaks requires a variety of approaches and usually more than one treatment. They showed that these methods can effectively treat the leak without needing to do a different type of operation.

FAQs

  1. What is a potential complication of laparoscopic sleeve gastrectomy?
  2. How are leaks from laparoscopic sleeve gastrectomy diagnosed and treated?
  3. How common are leaks after a laparoscopic sleeve gastrectomy and how long does it typically take for them to heal?

Doctor’s Tip

One helpful tip a doctor might tell a patient about gastrectomy is to closely follow post-operative instructions and attend all follow-up appointments to monitor for any potential complications, such as leaks. It is important to promptly report any symptoms such as persistent abdominal pain, fever, or difficulty eating or drinking. Early detection and treatment of a leak can help prevent serious complications and promote healing.

Suitable For

Patients who are typically recommended gastrectomy are those who are severely obese and have not been able to lose weight through other methods such as diet and exercise. This procedure is often recommended for individuals with a body mass index (BMI) of 40 or higher, or a BMI of 35 or higher with obesity-related health conditions such as diabetes, high blood pressure, or sleep apnea. It may also be recommended for patients with certain gastrointestinal conditions such as gastric cancer or severe gastroesophageal reflux disease (GERD).

Timeline

Before gastrectomy:

  • Patient consults with a healthcare provider to discuss weight loss options
  • Patient undergoes pre-operative testing and evaluation
  • Patient follows pre-operative diet and lifestyle changes as recommended by healthcare provider
  • Patient undergoes laparoscopic sleeve gastrectomy surgery

After gastrectomy:

  • Patient may experience pain and discomfort post-surgery
  • Patient follows post-operative diet and lifestyle changes as recommended by healthcare provider
  • Patient may experience weight loss and improvement in obesity-related health issues
  • Patient attends follow-up appointments with healthcare provider for monitoring and support
  • Rare complication of leak along the stapled line of the stomach may occur, typically presenting symptoms almost a month after surgery
  • Diagnosis of leak is confirmed using computed tomography scan
  • Treatment of leak may involve multiple procedures such as additional surgery or endoscopic intervention
  • Healing of leak typically takes an average of 48.2 days
  • Patient continues to follow-up with healthcare provider for long-term monitoring and support.

What to Ask Your Doctor

  1. What are the potential risks and complications of a gastrectomy, specifically regarding leaks along the stapled line?

  2. How likely is it for a leak to occur after a gastrectomy?

  3. What are the symptoms of a leak along the stapled line, and when should I seek medical attention if I suspect this complication?

  4. How is a leak along the stapled line diagnosed, and what imaging tests may be necessary?

  5. What are the treatment options for a leak along the stapled line, and how will the best course of action be determined?

  6. How long does it typically take for a leak along the stapled line to heal, and what is the recovery process like?

  7. Are there any long-term consequences or complications associated with a leak along the stapled line after a gastrectomy?

  8. Are there any specific precautions or lifestyle changes I should make to reduce the risk of developing a leak along the stapled line post-gastrectomy?

  9. How frequently should I follow up with my healthcare provider after a gastrectomy to monitor for potential complications, including leaks along the stapled line?

  10. Are there any additional resources or support groups available for patients who have undergone a gastrectomy and may be at risk for complications like leaks along the stapled line?

Reference

Authors: Parmer M, Wang YHW, Hersh EH, Zhang L, Chin E, Nguyen SQ. Journal: JSLS. 2022 Jul-Sep;26(3):e2022.00029. doi: 10.4293/JSLS.2022.00029. PMID: 36071996