Endoscopic stent placement can successfully treat gastric leak following laparoscopic sleeve gastrectomy if and only if an esophagoduodenal megastent is used

• Verfasst von: Billmann, Franck [VerfasserIn]
• Verfasst von: Pfeiffer, Aylin [VerfasserIn]
• Verfasst von: Sauer, Peter [VerfasserIn]
• Verfasst von: Billeter, Adrian [VerfasserIn]
• Verfasst von: Rupp, Christian [VerfasserIn]
• Verfasst von: Koschny, Ronald [VerfasserIn]
• Verfasst von: Nickel, Felix [VerfasserIn]
• Verfasst von: Frankenberg, Moritz von [VerfasserIn]
• Verfasst von: Müller, Beat P. [VerfasserIn]
• Verfasst von: Schaible, Anja [VerfasserIn]
• Titel: Endoscopic stent placement can successfully treat gastric leak following laparoscopic sleeve gastrectomy if and only if an esophagoduodenal megastent is used
• Verf.angabe: Franck Billmann, Aylin Pfeiffer, Peter Sauer, Adrian Billeter, Christian Rupp, Ronald Koschny, Felix Nickel, Moritz von Frankenberg, Beat Peter Müller-Stich & Anja Schaible
• Jahr: 2022
• Umfang: 10 S.
• Fussnoten: Online veröffentlicht: 03 November 2021 ; Gesehen am 10.07.2023
• Titel Quelle: Enthalten in: Obesity surgery
• Ort Quelle: New York, NY : Springer, 1991
• Jahr Quelle: 2022
• Band/Heft Quelle: 32(2022), 1, Seite 64-73
• ISSN Quelle: 1708-0428
• DOI: doi:10.1007/s11695-021-05467-x
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1852268360
• K10plus-PPN:
  Universitätsbibliothek
• Lokale URL UB: Zum Volltext

Abstract

Purpose Gastric staple line leakage (GL) is a serious complication of laparoscopic sleeve gastrectomy (LSG), with a specific mortality ranging from 0.2 to 3.7%. The current treatment of choice is stent insertion. However, it is unclear whether the type of stent which is inserted affects treatment outcome. Therefore, we aimed not only to determine the effectiveness of stent treatment for GL but also to specifically clarify whether treatment outcome was dependent on the type of stent (small- (SS) or megastent (MS)) which was used. Patients and Methods A single-centre retrospective study of 23 consecutive patients was conducted to compare the outcomes of SS (n = 12) and MS (n = 11) for the treatment of GL following LSG. The primary outcome measure was the success rate of stenting, defined as complete healing of the GL without changing the treatment strategy. Treatment change or death were both coded as failure. - Results The success rate of MS was 91% (10/11) compared to only 50% (6/12) for SS (p = 0.006). An average of 2.3 ± 0.5 and 6.8 ± 3.7 endoscopies were required to achieve healing in the MS and SS groups respectively (p < 0.001). The average time to resumption of oral nutrition was shorter in the MS group (1.4 ± 1.1 days vs. 23.1 ± 33.1 days, p = 0.003). - Conclusions Stent therapy is only effective and safe for the treatment of GL after LSG if a MS is used. Treatment with a MS may not only increase treatment success rates but may also facilitate earlier resumption of oral nutrition and shorten the duration of hospitalization.