Endoscopic Management of Staple Line Leak after Bariatric Surgery: Surgeon’s Perspective

다국어 초록 (Multilingual Abstract)

Laparoscopic sleeve gastrectomy (LSG) has become a standalone primary procedure as a bariatric metabolic surgery since the early2000s. The overall complication rate of LSG is reported to range from 2% to 15%. Staple line leakage (SLL) remains a major adverseevent and occurs in approximately 1–6% of patients. Choosing the optimal treatment modality is a complex process. Clinicians mustunderstand that nutritional support and drainage of fluid collection are essential for initial management. Conservative endoscopicmanagement and sufficient drainage can resolve approximately 70% of SLLs. Endoscopic management of bariatric complicationshas been rapidly evolving in recent years and can be considered in all patients who are hemodynamically stable. We will reviewthe available endoscopic management techniques, including stent placement (self-expanding stents and bariatric-specific stents),clipping, tissue sealant application, and internal drainage (double-pigtail stents [DPS] placement, endoscopic vacuum therapy, andseptotomy). Stent placement remains the mainstream treatment for SLLs. However, healing with stents requires multiple sessions/stents and a long course of recovery. Endoscopic internal drainage is gaining popularity and has the potential to be a superiormethod. The importance of early intervention and combined endoscopic methods should be recognized.

참고문헌 (Reference)

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