title: A Specifically Designed Stent for Anastomotic Leaks after Bariatric Surgery: Experiences in a Tertiary Referral Hospital.
abstract: The management of anastomotic leakage after either laparoscopic Roux-en-Y gastric bypass (LGBP) or laparoscopic sleeve gastrectomy (LSG) remains a burden. Various options are available for the treatment of these leaks. A newer and less invasive option for the treatment of leaks is the use of endoluminal stents. The main drawback for this treatment is stent migration. The current study describes the outcome of a new, specifically designed stent for the treatment of anastomotic leaks after bariatric surgery.
  
  
  
  For this retrospective observational study, the medical charts of patients undergoing bariatric surgery between October 1, 2010 and July 1, 2013 were reviewed. All patients with anastomotic leakage, treated with the bariatric Hanarostent, were included.
  
  
  
  Twelve patients were included out of a total of 1702 bariatric patients in the described period. Seven had a leakage after LSG, five after LGBP. An average of 2.4 endoscopic procedures and 1.25 stents were used per patient. Successful treatment was seen in nine out of 12 patients (75 %). Most common complication was dislocation or migration of the stent, occurring in eight patients (66.7 %).
  
  
  
  The ECBB Hanarostent®, which was specifically designed for post bariatric leakages, shows equal but not favorable success rates in this small series compared to previous reports on other types of stenting techniques. Despite the stent design, the complication rate is not reduced and the main future goal should be to target the high stent migration rate.
authors.affiliation: Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands. martin.v.wezenbeek@catharinaziekenhuis.nl.|Department of Bariatric Surgery, Catharina Hospital, P.O. Box 1350, 5602 ZA, Eindhoven, The Netherlands. martin.v.wezenbeek@catharinaziekenhuis.nl.
authors.forename: Martin R
authors.initials: MR
authors.lastname: van Wezenbeek
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
authors.forename: Martine M
authors.initials: MM
authors.lastname: de Milliano
authors.affiliation: Department of Surgery, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
authors.forename: Simon W
authors.initials: SW
authors.lastname: Nienhuijs
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
authors.forename: Pieter
authors.initials: P
authors.lastname: Friederich
authors.affiliation: Department of Gastroenterology and Hepatology, Catharina Hospital, Michelangelolaan 2, 5623 EJ, Eindhoven, The Netherlands.
authors.forename: Lennard P L
authors.initials: LP
authors.lastname: Gilissen
mesh_terms: D000328:Adult; D057868:Anastomotic Leak / Q000209:etiology / Q000601:surgery*; D050110:Bariatric Surgery / Q000009:adverse effects*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D009767:Obesity, Morbid / Q000601:surgery*; D011183:Postoperative Complications / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012189:Retrospective Studies; D015607:Stents; D062606:Tertiary Care Centers; D016896:Treatment Outcome; D055815:Young Adult
keywords: Anastomotic leakage; Bariatric surgery; Endoscopic stent; Gastric bypass; SEMS; Sleeve gastrectomy