Gastric leak after laparoscopic sleeve gastrectomy: management with endoscopic double pigtail drainage. A systematic review

Surg Obes Relat Dis. 2019 Aug;15(8):1414-1419. doi: 10.1016/j.soard.2019.03.019. Epub 2019 Mar 20.

Abstract

Gastric leak remains the main complication after sleeve gastrectomy, but there are no standardized guidelines for its treatment. Good results have been reported using endoscopic double-pigtail stent. To estimate its effectiveness, we carried out this systematic review. Eleven eligible articles were identified by searching PubMed, Embase, and Cochrane Library databases. A total of 385 patients met the inclusion criteria. The pooled proportion of successful leak closures by using double pigtail drainage was 83.41%. The proportion of successful leak closures by using double pigtail drainage by experienced operators as first-line treatment was 84.71%. Our review suggested that double-pigtail stent could be a valid approach to manage the postbariatric gastric leak, with low rate of complications and a good tolerance by patients. More high-quality studies with large samples sizes should be undertaken to better evaluate and compare the variety of techniques available.

Keywords: Fistula; Internal drainage; Leak; Pigtail; Sleeve; Systematic review.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Anastomotic Leak / surgery*
  • Drainage / methods*
  • Female
  • Gastrectomy / adverse effects*
  • Humans
  • Laparoscopy / adverse effects*
  • Male
  • Middle Aged
  • Obesity / surgery
  • Reoperation / methods*