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• W2913373009 abstract "Introduction: Leaks after bariatric surgery (BS) are considered a life threating complication and are a therapeutic challenge. Endoluminal stent therapy (EST) is a less-invasive alternative to surgery and an emerging therapeutic strategy for postoperative leaks after BS. Our aim to evaluate the safety and efficacy of endoscopically placed, self-expandable metal stents (SEMS) in bariatric patients with postoperative leaks. Methods: A retrospective cohort study of consecutive patients who, between 2009 and 2016, underwent endoscopically placed SEMS at a tertiary center for early (< 30days) and late (30 days or more) postoperative leaks. Success of SEMS treatment was defined as radiographic evidence of leak closure after stent removal. Patients with persistent leaks despite EST were treated with surgery or with conservative therapy include antibiotics, total parenteral nutrition (TPN) and percutaneous drainage (PD). Patients were followed until the time of leak resolution or death. Demographics, clinical characteristics, procedural details, and adverse events were abstracted from a review of the medical records. Results: The cohort was composed of 8 patients, all women, with a median age of 51 years (24-64). The bariatric surgical procedures were 4 Roux-en-y gastric bypass, 3 laparoscopic sleeve gastrectomy and 1 laparoscopic band surgery(LBS). Leaks were classified as early in 2 patients and late in 6 patients. All leaks were at the anastomosis or staple line except LBS patient who had a leak related to band erosion. Four (50%) patients had surgical revision prior to EST in an attempt to correct the leak. The median follow-up duration from stent placement to removal was 46 days (16-126). Despite EST, four patients (50%) did not have leak resolution. Out of this group,3 had an attempt at surgical revision prior to EST compared to one patient in the group who cured with EST. Among patients who failed EST; 2 were subsequently treated with surgical revision with leak resolution, 1 died from cardiac event unrelated to the leak or EST and 1 died from refractory GI bleeding due to stent erosion. Six patients had stent migration of which 4 patients underwent endoscopic removal of the stent and 1 patient underwent surgical removal. Conclusion: EST can serve as a definitive therapy for post-BS leaks. However, in our cohort, there was an associated high stent migration and complication rate. We observed that EST was less effective in patients who had a persistent leak after an attempt at surgical revision." @default.
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• W2913373009 date "2017-10-01" @default.
• W2913373009 modified "2023-09-26" @default.
• W2913373009 title "Endoluminal Stent Therapy for Leaks After Bariatric Surgery" @default.
• W2913373009 doi "https://doi.org/10.14309/00000434-201710001-00855" @default.
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