PT  - JOURNAL ARTICLE
AU  - Guzaiz, Noha
AU  - Arabi, Mohammad
AU  - Khankan, Azzam
AU  - Salman, Refaat
AU  - Al-Toki, Mohammed
AU  - Qazi, Shahbaz
AU  - Alzakari, Abdulmohsin
AU  - Al-Moaiqel, Mohammad
TI  - Gastroesophageal stenting for the management of post sleeve gastrectomy leak
AID  - 10.15537/smj.2016.12.15761
DP  - 2016 Dec 01
TA  - Saudi Medical Journal
PG  - 1339--1343
VI  - 37
IP  - 12
4099  - http://smj.org.sa/content/37/12/1339.short
4100  - http://smj.org.sa/content/37/12/1339.full
SO  - Saudi Med J2016 Dec 01; 37
AB  - Objectives To retrospectively evaluate the effectiveness of gastroesophageal stenting for post sleeve gastrectomy staple line leaks using removable self-expandable stents.Methods Between April 2012 and June 2015, 12 consecutive patients (6 males) with mean age of 34 years: (21-38 years) presented with staple line leak 1-8 weeks after the operation (mean 2.8 weeks). Patients underwent gastroesophageal stenting by interventional radiology. A total of 23 stents were deployed with mean length of 17.8 cm (7-24 cm) and mean diameter 25.6 mm (18-36 mm). Stent re-insertion was needed in 7 patients (9 procedure), while 6 patients required percutaneous collection drainage and 3 patients required endoscopic glue injection with clipping. Two stent removal procedures were carried out under endoscopic visualization after failed stent capture under fluoroscopy, while the remaining stents were successfully removed by interventional radiology.Results Stent placement was technically successful in all patients. Stent migration occurred in 6 patients (50%). There is a tendency for stent migration with shorter stent length (R= -0.557, p=0.008). The mean duration of stenting was 60.5 days (14-137 days). All patients underwent stent removal and resumed oral intake with no recurrence of leak at a mean follow up time of 190 days (14-410 days). Complications included gastrointestinal bleeding (n=1), proximal esophageal stricture (n=1) and stent occlusion (n=1).Conclusion Gastroesophageal stenting as a primary measure after diagnosis of early post sleeve gastrectomy leak appears to offer a safe and effective alternative option in obviating repeat surgical interventions. Minimally invasive interventions may still be required for the management of persistent leak.