9th Annual Association for Bariatric Endoscopy (ABE) Meeting | May 2024 ABEAM2024-Sleeve Leaks: Evolving Endoscopic & Surgical Management Options + Panel Discussion

Sleeve Leaks: Evolving Endoscopic & Surgical Management Options + Panel Discussion

Pdf Summary

A 33-year-old female with a BMI of 47.7 underwent a laparoscopic sleeve gastrectomy without complications but was readmitted on POD #8 with symptoms of infection, leading to the diagnosis of a 3cm staple line leak 3cm below the gastroesophageal junction. Endoscopic procedures were performed to address the leak and infected hematoma, including an Endovac placement. Despite initial challenges with the vacuum system, the patient eventually underwent a laparoscopic washout, received an omental patch and a covered metal gastric stent, and was discharged home with improvement. A month later, the stent was removed with no residual defect or stenosis noted. However, three months later, a recurrent leak was detected, requiring the placement of a Double J stent and surgical intervention with resolution achieved after stent removal. The patient was able to tolerate a regular diet post-treatment.

Asset Subtitle

Trevor Crafts, MD

Keywords

laparoscopic sleeve gastrectomy

staple line leak

gastroesophageal junction

endoscopic procedures

Endovac placement

infected hematoma

laparoscopic washout

metal gastric stent

Double J stent

recurrent leak