Cargando…
Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience
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...
Autores principales: | , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Saudi Medical Journal
2016
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303772/ https://www.ncbi.nlm.nih.gov/pubmed/27874149 http://dx.doi.org/10.15537/smj.2016.12.15761 |
_version_ | 1782506756210950144 |
---|---|
author | Guzaiz, Noha Arabi, Mohammad Khankan, Azzam Salman, Refaat Al-Toki, Mohammed Qazi, Shahbaz Alzakari, Abdulmohsin Al-Moaiqel, Mohammad |
author_facet | Guzaiz, Noha Arabi, Mohammad Khankan, Azzam Salman, Refaat Al-Toki, Mohammed Qazi, Shahbaz Alzakari, Abdulmohsin Al-Moaiqel, Mohammad |
author_sort | Guzaiz, Noha |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-5303772 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Saudi Medical Journal |
record_format | MEDLINE/PubMed |
spelling | pubmed-53037722017-02-16 Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience Guzaiz, Noha Arabi, Mohammad Khankan, Azzam Salman, Refaat Al-Toki, Mohammed Qazi, Shahbaz Alzakari, Abdulmohsin Al-Moaiqel, Mohammad Saudi Med J Original Article 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. Saudi Medical Journal 2016-12 /pmc/articles/PMC5303772/ /pubmed/27874149 http://dx.doi.org/10.15537/smj.2016.12.15761 Text en Copyright: © Saudi Medical Journal http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Guzaiz, Noha Arabi, Mohammad Khankan, Azzam Salman, Refaat Al-Toki, Mohammed Qazi, Shahbaz Alzakari, Abdulmohsin Al-Moaiqel, Mohammad Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience |
title | Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience |
title_full | Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience |
title_fullStr | Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience |
title_full_unstemmed | Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience |
title_short | Gastroesophageal stenting for the management of post sleeve gastrectomy leak: A single institution experience |
title_sort | gastroesophageal stenting for the management of post sleeve gastrectomy leak: a single institution experience |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5303772/ https://www.ncbi.nlm.nih.gov/pubmed/27874149 http://dx.doi.org/10.15537/smj.2016.12.15761 |
work_keys_str_mv | AT guzaiznoha gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience AT arabimohammad gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience AT khankanazzam gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience AT salmanrefaat gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience AT altokimohammed gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience AT qazishahbaz gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience AT alzakariabdulmohsin gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience AT almoaiqelmohammad gastroesophagealstentingforthemanagementofpostsleevegastrectomyleakasingleinstitutionexperience |