scholarly journals DRAIN AMYLASE LEVELS IN THE EARLY DIAGNOSIS OF GASTRIC LEAK AFTER LAPAROSCOPIC SLEEVE GASTRECTOMY

Author(s):  
Lucia Romano ◽  
Antonio Giuliani ◽  
Marino Di Furia ◽  
Danilo Meloni ◽  
Giovanni Cianca ◽  
...  
2010 ◽  
Vol 20 (9) ◽  
pp. 1306-1311 ◽  
Author(s):  
Manuel Ferrer Márquez ◽  
Manuel Ferrer Ayza ◽  
Ricardo Belda Lozano ◽  
María del Mar Rico Morales ◽  
Jose Miguel García Díez ◽  
...  

2021 ◽  
Author(s):  
Piotr Zarzycki ◽  
Jan Kulawik ◽  
Piotr Małczak ◽  
Mateusz Rubinkiewicz ◽  
Mateusz Wierdak ◽  
...  

Abstract Purpose Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric procedure worldwide. Omentopexy during LSG is a novel variation of this well-established technique. There are no clear conclusions on indications for this procedure, safeness, and effects of such a method. We aimed to compare the outcomes of laparoscopic sleeve gastrectomy (LSG) with omentopexy (OP) and without omentopexy. Materials and Methods We searched the Medline, EMBASE, and Scopus databases up-to June 2020. Full-text articles and conference abstracts were included for further analysis. This review follows the PRISMA guidelines. Results Of initial 66 records, only 4 studies (N = 1396 patients) were included in the meta-analysis. Our findings showed that LSG with omentopexy had significantly lowered overall morbidity compared to LSG without omentopexy (RR = 0.38; 95% CI [0.15, 0.94]; p=0.04). Gastric leakage rate (RR = 0.17; 95% CI [0.04, 0.76]; p = 0.02) was also significantly lower in LSG with omentopexy. There were no significant differences between groups in length of hospital stay. Conclusions Our meta-analysis showed that LSG with omentopexy may be a feasible procedure for decreasing morbidity and gastric leak rate. However, despite promising results, the procedure needs to be researched more in randomized controlled studies to draw solid conclusions.


2019 ◽  
Vol 6 (12) ◽  
pp. 4530
Author(s):  
Omar Hasheesh Al-Bogami ◽  
Abdullah Saeed Al-Zahrani ◽  
Bandar Idrees Ali

Bariatric surgery is evolving worldwide nowadays. Postoperative complications are mainly represented by gastric leak reported range between 1% to 3.3%. The worse scenario of the leak post laparoscopic sleeve gastrectomy is a fistula. Many types of fistula were prescribed and one of the theses is gastrobronchial one. It has a catastrophic sequela if not diagnosed and treated efficiently early. It is difficult to manage either radiologically, endoscopically or surgically. No clear consensus yet for the standard of treatment for such complication especially if these patients are immunocompromised was the mortality will be very high. Therefore, we aim to contribute our successful approach to treating our patient. We report a case of a 27-year-old female who is obese with systemic lupus erythematous controlled medically underwent laparoscopic sleeve gastrectomy. 6 months later she presented to the hospital with productive cough post-operative stenting and esophageal dilation was performed. 15 months post LSG patient presented with productive cough with green sputum, food particle, and left-sided chest pain. Endoscopic clip placement was attempted with no avail. The management of gastrobronchial fistulas involves a comprehensive clinical evaluation. In the absence of red flags, initial conservative management should be undertaken. When all else fail, surgery is the only route towards a permanent and definitive treatment. The need for further research and consensus is of utmost importance to guide future surgeons and to increase awareness among the medical community, due to its presentation under the facade of common symptoms.


2021 ◽  
Vol 108 (Supplement_7) ◽  
Author(s):  
Yi-Tzu Linda Lin ◽  
Hock Ping Cheah ◽  
Kenneth Wong

Abstract Introduction Length of stay (LOS) in laparoscopic sleeve gastrectomy (LSG) is affected by multiple factors, including gender, BMI >50, comorbidities, socioeconomic status and increased operative time (OT). This study aimed to evaluate the effect of reduced OT on LOS. Methods Analysis was conducted using a prospective database in patients who underwent LSG by a single surgeon at a single institution from January 2015 to December 2019. Patients receiving other operations (e.g. adhesiolysis, cholecystectomy, para-oesophageal hiatal hernia repair or ventral hernia repair) during LSG were excluded. All the patients were divided into two groups: OT ≤ 60 minutes and OT > 60 minutes. Patient demographics and outcome variables, including LOS, 30-day readmission, unexpected return to operating theatre, complications and mortality, were collected and analysed. Results A total of 1412 patients were included. In OT ≤ 60 minutes group (N = 804), the average LOS was 1.37 days and the average operative time was 51.31 minutes. In OT > 60 minutes group (N = 608), the average LOS was 1.66 days and the average operative time was 77.95 minutes. OT ≤ 60 minutes group showed a statistically significant decrease in LOS compared to OT > 60 minutes group (P-value <0.0001). The 30-day readmission rate was 0.97%. Complications included one gastric leak (0.07%), one postoperative bleeding requiring reoperation (0.07%), three (0.21%) portal vein thrombosis, and no mortality. Conclusion Our study demonstrated that reduced OT (≤60 minutes) in LSG was associated with reduced LOS but without increase in complication rates and mortality. This has implications for economic considerations for both hospitals and patients, especially in self-funded payer models.


2015 ◽  
Vol 26 (3) ◽  
pp. 494-504 ◽  
Author(s):  
Tamer Youssef ◽  
Emad Abdalla ◽  
Khalid El-Alfy ◽  
Ibrahim Dawoud ◽  
Mosaad Morshed ◽  
...  

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hung-Hsuan Yen ◽  
Yu-Ting Lin ◽  
Jin-Ming Wu ◽  
Kao-Lang Liu ◽  
Ming-Tsan Lin

Abstract Background The management for subacute or chronic fistula after bariatric surgery is very complicated and with no standard protocol yet. It is also an Achilles’ heel of all bariatric surgery. The aim of this case report is to describe our experience in managing this complication by percutaneous embolization, a less commonly used method. Case presentation A 23-year-old woman with a body mass index of 35.7 kg/m2 presented with delayed gastric leak 7 days after laparoscopic sleeve gastrectomy (LSG) for weight reduction. Persistent leak was still noted under the status of nil per os, nasogastric decompression, and parenteral nutrition for 1 month; therefore, endoscopic glue injection was performed. The fistula tract did not seal off, and the size of pseudocavity enlarged after gas inflation during endoscopic intervention. Subsequently, we successfully managed this subacute gastric fistula via percutaneous fistula tract embolization (PFTE) with removal of the external drain 2 months after LSG. Conclusions PFTE can serve as one of the non-invasive methods to treat subacute gastric fistula after LSG. The usage of fluoroscopy-visible glue for embolization can seal the fistula tract precisely and avoid the negative impact from gas inflation during endoscopic intervention.


Sign in / Sign up

Export Citation Format

Share Document