title: Management of postsurgical leaks in the bariatric patient.
abstract: Postsurgical leaks after bariatric procedures are a significant cause of morbidity and mortality. They usually arise from anastomotic and staple line failures that are attributed to surgical technique, ischemia, and patient comorbid conditions. Timely diagnosis from subtle clinical clues is the key to appropriate management. Traditional treatment consists of adequate control of the intra-abdominal infection via surgical or percutaneous drainage maneuvers, antibiotics, and nutrition support via parenteral or feeding tube routes. Recently, endoscopically placed covered esophageal stents have been used to exclude the leak site, allowing oral nutrition and speeding healing.
authors.affiliation: SSM Weight-Loss Institute, DePaul Health Center, SSM Health Care, 12266 DePaul Drive Suite 310, St Louis, MO 63044, USA. mpmoralesmd@yahoo.com
authors.forename: Mario P
authors.initials: MP
authors.lastname: Morales
authors.forename: Brent W
authors.initials: BW
authors.lastname: Miedema
authors.forename: J Stephen
authors.initials: JS
authors.lastname: Scott
authors.forename: Roger A
authors.initials: RA
authors.lastname: de la Torre
mesh_terms: D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D050110:Bariatric Surgery / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D009767:Obesity, Morbid / Q000601:surgery*; D015607:Stents