title: Treatment of leaking gastrojejunostomy after gastric bypass surgery with special emphasis on stenting.
abstract: BACKGROUND
  Gastric bypass is one of the most common operations for morbid obesity. One of the most feared complications is a leak, most commonly encountered in the gastrojejunal anastomosis (GJA), leading to significant morbidity and increased costs. Our objective was to evaluate the effectiveness of stenting leaks in the GJA. The setting was a university hospital in Stockholm, Sweden.
  
  
  METHODS
  We performed a retrospective analysis of all gastric bypasses from January 2001 to August 2011, with special reference to the treatment of leaks in the GJA.
  
  
  RESULTS
  A postoperative leak in the GJA occurred in 69 of 2214 patients. The risk was greater with open surgery and revisional surgery. The risk was also greater with age >50 years but not with a body mass index >50 kg/m(2). There was no mortality. In the later part of the series, stents were used, with a stent time of 2 weeks. The migration rate was 23%, and need for restenting was 20%.
  
  
  CONCLUSIONS
  It is safe and advantageous to use stents in the treatment of leaks at the GJA. Patients can be on oral nutrition and oral medication, reducing the need for in-hospital care.
authors.affiliation: Division of Surgery, Department of Clinical Sciences, Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. jacob.freedman@ds.se
authors.forename: Jacob
authors.initials: J
authors.lastname: Freedman
authors.forename: Eduard
authors.initials: E
authors.lastname: Jonas
authors.forename: Erik
authors.initials: E
authors.lastname: Näslund
authors.forename: Henrik
authors.initials: H
authors.lastname: Nilsson
authors.forename: Richard
authors.initials: R
authors.lastname: Marsk
authors.forename: Dag
authors.initials: D
authors.lastname: Stockeld
mesh_terms: D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000601:surgery*; D004322:Drainage / Q000379:methods; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011475:Prosthesis Failure; D012086:Reoperation; D012189:Retrospective Studies; D012307:Risk Factors; D015607:Stents; D013536:Suture Techniques; D016896:Treatment Outcome