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Gastric leak after sleeve gastrectomy: risk factors for poor evolution under conservative management
- Source :
- Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 17(5)
- Publication Year :
- 2020
-
Abstract
- Background Gastric leak (GL) is the most highly feared early postoperative complication after sleeve gastrectomy (SG), with an incidence of 1% to 2%. This complication may require further surgery/endoscopy, with a risk of management failure that may require additional surgery, including total gastrectomy, leading to a risk of mortality of 0% to 9%. Objectives Assess the impact of factors that may lead to a poorer evolution of GL. Setting University Hospital, France, public practice. Methods This was a retrospective, single-center study of a group of patients managed for GL after SG between November 2004 and January 2019 (n = 166). Forty-three patients were excluded. The population study was divided into 2 groups: patients with easy closing of the GL (n = 73) and patients with difficult closing of the GL or failure to heal (n = 50). Patients were allocated to 1 of 2 groups depending on the time to heal (median time of 84 days). The study's primary efficacy endpoint was to determine the risk factors for a poorer evolution of GL. Results Among 123 patients included in this study, 103 patients had undergone primary SG (83.7%). The mean time to the appearance of GL was 15.1 days (range, 1–156 d). Seventy-four patients underwent a reoperation (60%). The mean number of endoscopies per patient was 2.7 (range, 2–7 endoscopies). The mean time to healing was 89.5 days (range, 18–386 d). There were 8 cases of healing failure (6.5%). Multivariate analysis identified body mass index (>47 kg/m2), time to referral (>2 d), and serum prealbumin level ( Conclusion Improvement of nutritional status before SG and early referral for GL could reduce the risk of delayed closure or the need for further surgery.
- Subjects :
- Reoperation
Sleeve gastrectomy
medicine.medical_specialty
medicine.medical_treatment
030209 endocrinology & metabolism
Anastomotic Leak
Conservative Treatment
03 medical and health sciences
0302 clinical medicine
Postoperative Complications
Gastrectomy
Risk Factors
medicine
Risk of mortality
Humans
Retrospective Studies
business.industry
Incidence (epidemiology)
Postoperative complication
Surgery
Obesity, Morbid
Treatment Outcome
Population study
030211 gastroenterology & hepatology
Laparoscopy
France
Complication
business
Body mass index
Subjects
Details
- ISSN :
- 18787533
- Volume :
- 17
- Issue :
- 5
- Database :
- OpenAIRE
- Journal :
- Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery
- Accession number :
- edsair.doi.dedup.....42360c61b1c25b99dc015dde80335e0c