Leakage Management after Laparoscopic Sleeve Gastrectomy: A Tertiary Center Experience in Saudi Arabia

Abstract

Purpose: The goal of this study was to determine the optimal method for treating gastric leaks in terms of resolution rate, complications, admission to the intensive care unit (ICU), conversion to other surgical techniques, and mortality. Methods: A retrospective analysis of patients treated at King Abdul-Aziz Specialist Hospital between 2017 and 2021 for post-LSG leaks. Age, gender, body mass index (BMI), preoperative comorbidities, leak rate, the interval between surgery and leak, the onset and site of leak, as well as the management lines and outcomes, were collected. Results: The leak rate following Laparoscopic Sleeve Gastrectomy (LSG) at our hospital was 0.53 percent, and there were no statistically significant differences in the demographic characteristics of patients with and without leaks. Despite the fact that 87.5 percent of patients were women, this was not statistically significant (P-value:0.09). The mean± SD interval between surgery and leak is 14 ±18.4, with early and acute leaks being the most common. Failure of first-line management, stent migration, and esophageal stricture were the most commoncomplications of leak management in our study. The mean length of hospital stays was 42.4 ±17.1 days, and the mortality rate was 12.5%. Conclusions: Leak after LSG is a drastic complication associated with substantial morbidity and mortality if diagnosis and treatment are delayed. Depending on the patient’s condition, location of the leak, and the time of diagnosis,; leak management may involve conservative, endoscopic, or surgical approaches. There are numerous measures that could be taken to reduce the leak incidence rate. Keywords: Bariatric surgery; Sleeve Gastrectomy; Leak; Treatment; Outcomes