LEAKAGE IN BARIATRIC SURGERY: A 10-YEAR EXPERIENCE | ||||
| The Egyptian Journal of Surgery | ||||
| Article 6, Volume 30, Issue 4, October 2011, Page 163-168 PDF (555.53 K) | ||||
| Document Type: Original Article | ||||
| DOI: 10.21608/ejsur.2011.367350 | ||||
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| Authors | ||||
| Khaled Katri* ; Wael Nabil; Mohamed Sharaan; El Said El Kayal | ||||
| Department of General Surgery, Faculty of Medicine, Alexandria University | ||||
| Abstract | ||||
| Background: Leakage is a dreaded complication of bariatric surgery. The aim of this study was to describe the clinical presentation and outcomes of treatment in patients who develop gastrointestinal leaks after bariatric surgery. Methods: Retrospective review of 632 consecutive bariatric surgical procedures performed from 1999-2009 in Alexandria University Hospital, Egypt. Results: leakage occurred in 10 patients. Symptoms and signs included tachycardia, fever, tachypnea, left shoulder pain, abdominal pain, chest pain, and/or change in the nature of the drain effluent. The average time to diagnosis was 3.9±2.6 days. Six leaks occurred after laparoscopic vertical banded gastroplasty (6.3%), 2 after laparoscopic gastric bypass (3.6%), one after open gastric bypass (2.3%), and 1 after laparoscopic sleeve gastrectomy (2.4%). The most common leak location was at the esophagogastric junction (70%). Four patients (40%) required reoperations. A percutaneous abdominal drainage was placed in five patients (50%). In 2 patients (20%), the prophylactic drain was maintained in situ till cessation of leakage. Two patients (20%) died. Mean hospital length of stay was 13.9±7.8 days. Conclusions: Leakage is a serious complication after bariatric surgery with a significant mortality. Patients with signs of sepsis or hemodynamic instability require emergent exploration. Leaks that are more insidious may be treated successfully with percutaneous drainage or maintenance of prophylactic drains. | ||||
| Keywords | ||||
| Morbid obesity; bariatric surgery; complication; leak | ||||
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