Treatments for Staple Line Leakage after Laparoscopic Sleeve Gastrectomy

Journal of Clinical Medicine · 13 authors, 1 centre

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TL;DR

This narrative review discusses the management of staple line leakage following laparoscopic sleeve gastrectomy, emphasizing the importance of early detection and a multimodal treatment approach involving conservative, endoscopic, and surgical options.

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This narrative review synthesizes peer-reviewed literature on the diagnosis and treatment of staple line leakage after laparoscopic sleeve gastrectomy (LSG), a complication occurring in 0.7% to 5% of cases. The authors describe leakage management, including conservative treatments like drainage and nutrition, endoscopic interventions, and revisional surgery. They note that while initial treatments are generally agreed upon, subsequent strategies require personalized consideration of factors like leak timing, size, and patient condition. The review highlights challenges, including limited high-quality evidence, varying regional treatment options, and the potential for increased surgical risk in reoperations. It concludes by stressing the need for healthcare professional education and collaboration to improve outcomes.

STUDY TYPE

narrative_review

SPECIALTY

surgery

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100% · A

ORIGINAL PAPER

PMC10219311

Treatments for Staple Line Leakage after Laparoscopic Sleeve Gastrectomy

Journal of Clinical Medicine

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ABSTRACT

The number of laparoscopic sleeve gastrectomies (LSGs) performed in patients with obesity who are eligible for bariatric and metabolic surgery is currently much lower in Japan than in other countries. Considering the large number of potential patients with obesity and type 2 diabetes and the unique Japanese national health insurance system that guarantees fair healthcare delivery, there is room to increase the number of LSGs in Japan in the near future. However, strict health insurance regulations may limit access to mandatory devices needed to treat postoperative complications, such as staple line leakage, which can cause severe morbidity and even mortality. Therefore, understanding the pathogenesis and treatment options for this complication is crucial. This article examined the current situation in Japan and its impact on staple line leakage management, including the role of endoscopic treatment in reducing reoperation. The authors suggest increasing education and collaboration between healthcare professionals to optimize management and improve patient outcomes.

CITATION EXPORT

Takashi Oshiro, Kotaro Wakamatsu, Taiki Nabekura et al.. Treatments for Staple Line Leakage after Laparoscopic Sleeve Gastrectomy. Journal of Clinical Medicine. (2023). https://doi.org/10.3390/jcm12103495

AUTHORS

13 · 1 CENTRES

Takashi Oshiro, Kotaro Wakamatsu, Taiki Nabekura, Yuki Moriyama, Natsumi Kitahara, Kengo Kadoya, Ayami Sato, Tomoaki Kitahara, Tasuku Urita, Yu Sato, Makoto Nagashima, Masaru Tsuchiya, Shinichi Okazumi

Department of Surgery, Toho University Sakura Medical Center, Sakura 285-8741, Japan; [email protected] (K.W.); [email protected] (T.N.); [email protected] (Y.M.); [email protected] (N.K.); [email protected] (K.K.); [email protected] (A.S.); [email protected] (T.K.); [email protected] (T.U.); [email protected] (Y.S.); [email protected] (M.N.);

EDITOR / REVIEWER

David Benaiges Boix