title: Successful management of staple line leak after laparoscopic sleeve gastrectomy with vascular plug and covered stent.
abstract: OBJECTIVE
  Laparoscopic sleeve gastrectomy (LSG) is a feasible option for morbid obesity. But gastric leak is one of the most dreadful complications. We report our experience of staple line leak, which was managed successfully with vascular plug and covered stent.
  
  
  METHODS
  A staple line leak occurred after LSG. Followed attempts of reoperation, drainage procedures of abscess cavity, and repeated endoscopic treatments were all unavailing. Finally, vascular plug was placed at fistula tract and consequent endoscopic covered stent placement could propose the solution.
  
  
  RESULTS
  Granulation tissue, which occluded the fistula tract was identified by computed tomographic scan 2 weeks after stent placement. Leak healed successfully, and the patient discharged safely a week after stent removal.
  
  
  CONCLUSIONS
  We consider inducing granulation tissue by applying vascular plug at fistula tract in combination with covered stent placement, which is a safe and effective therapeutic option for management of intractable staple line leak after LSG.
authors.affiliation: Department of Surgery, Soonchunhyang University College of Medicine, Seoul, Korea.
authors.forename: Zisun
authors.initials: Z
authors.lastname: Kim
authors.forename: Yong Jin
authors.initials: YJ
authors.lastname: Kim
authors.forename: Yong Jae
authors.initials: YJ
authors.lastname: Kim
authors.forename: Dong Erk
authors.initials: DE
authors.lastname: Goo
authors.forename: Joo Young
authors.initials: JY
authors.lastname: Cho
mesh_terms: D057868:Anastomotic Leak / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D020099:Coated Materials, Biocompatible; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D012086:Reoperation; D015607:Stents; D013536:Suture Techniques / Q000295:instrumentation*; D013537:Sutures; D017211:Treatment Failure; D055815:Young Adult
chemical_list: D020099:Coated Materials, Biocompatible