title: Gastric leak after sleeve gastrectomy: analysis of its management.
abstract: BACKGROUND
  Bariatric surgery is increasingly being performed and sleeve gastrectomy (SG) has proved to be effective and safe. Among its complications, leaks are the most serious and life threatening.
  
  
  METHODS
  The focus of the study is nine patients who underwent a SG and developed a gastric leak after surgery. Our data were obtained from the clinical charts of the patients and through interviews with the surgeon who performed the index surgery.
  
  
  RESULTS
  Eight patients underwent SG at outside institutions while one was operated at Clinica Alemana. Three patients developed symptoms within 5 days after surgery, while the rest were diagnosed after 10 days from the surgery. A CT scan was the method used to confirm the diagnosis in all patients. The three patients who had a leak detected during the immediate postoperative period underwent laparoscopic reoperation. Among the rest of the patients, percutaneous drainage was employed in one patient as the primary procedure while the other underwent surgical drainage. An esophageal endoluminal stent was employed in four patients. The leak closed in all patients with the healing time ranging from 21 to 240 days.
  
  
  CONCLUSIONS
  Diagnosis of a leak after a SG required a greater index of suspicion in order to perform an early diagnosis. Sepsis control and nutritional support are the cornerstones of this treatment. Evolution is characterized by longer periods of time that are necessary in order to wait until the leak closes. Management must be tailored to each patient.
authors.affiliation: Obesity Unit, Clinica Alemana, Santiago, Chile. xdearetxabala@alemana.cl
authors.forename: Xabier
authors.initials: X
authors.lastname: de Aretxabala
authors.forename: Jorge
authors.initials: J
authors.lastname: Leon
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Wiedmaier
authors.forename: Ivan
authors.initials: I
authors.lastname: Turu
authors.forename: Cristian
authors.initials: C
authors.lastname: Ovalle
authors.forename: Fernando
authors.initials: F
authors.lastname: Maluenda
authors.forename: Carolina
authors.initials: C
authors.lastname: Gonzalez
authors.forename: Jennifer
authors.initials: J
authors.lastname: Humphrey
authors.forename: Mabel
authors.initials: M
authors.lastname: Hurtado
authors.forename: Carlos
authors.initials: C
authors.lastname: Benavides
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000000981:diagnostic imaging / Q000601:surgery / Q000628:therapy*; D004322:Drainage / Q000295:instrumentation / Q000379:methods; D004750:Enteral Nutrition; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D015607:Stents; D014057:Tomography, X-Ray Computed; D055815:Young Adult