title: Laparoscopic sleeve gastrectomy - 7 years of own experience.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy is a procedure frequently chosen by patients and surgeons that carries the risk of serious complications that are difficult to treat.
  
  
  OBJECTIVE
  To describe the operations performed by us, considering complications and their management.
  
  
  METHODS
  We performed 565 laparoscopic sleeve gastrectomies. Standard surgical technique was used. A 34 Fr calibration tube was used. An additional reinforcing suture was applied over the staple line.
  
  
  RESULTS
  There was no need for conversion. In 7.79% of patients, infarcts of the posterior pole of the spleen were observed, whereas 8 patients (1.42%) developed gastric fistulas in the His angle region. In 3 cases, it led to development of an abscess in the posterior splenic pole region and 2 of these developed secondary gastric fistulas of typical location. In total, there were 5 deaths among the patients who had been operated on - 3 due to septic complications in the course of fistula, 1 due to encephalopathy and 1 as a result of myocardial infarction.
  
  
  CONCLUSIONS
  Sleeve gastrectomy is an effective and safe method of obesity treatment. The causes of the most severe complication - gastric fistula - cannot be established unequivocally. Infarcts of the posterior pole of the spleen, as a potential cause of fistulas, deserve particular attention. In our opinion, primary closure of the fistula by suturing is an inappropriate method of management, whereas the best results are obtained with temporary gastrointestinal tract prosthesis.
authors.affiliation: Department of Gastroenterology, Oncology and General Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Szewczyk
authors.affiliation: Department of Gastroenterology, Oncology and General Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: Przemyslaw
authors.initials: P
authors.lastname: Janczak
authors.affiliation: Department of Gastroenterology, Oncology and General Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: Adam
authors.initials: A
authors.lastname: Janiak
authors.affiliation: Department of Emergency and Disaster Medicine, Medical University of Lodz, Lodz, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Gaszyński
authors.affiliation: Department of Gastroenterology, Oncology and General Surgery, Medical University of Lodz, Lodz, Poland.
authors.forename: Bogdan
authors.initials: B
authors.lastname: Modzelewski
keywords: complications; leak; sleeve; stent