Cone-beam computerized tomography fluoroscopy-guided percutaneous drainage for the treatment of leakage after laparoscopic sleeve gastrectomy
Öz
Aim: This study aimed to review the technical and clinical results of cone-beam computed tomography (CBCT) fluoroscopy-guided drainage of anastomosis or staple line leakage, which is the most important complication after laparoscopic sleeve gastrectomy due to obesity.
Methods: A retrospective analysis was performed of the demographic findings, clinical manifestations, leakage location, and medical data of 30 cases who underwent CBCT fluoroscopy-guided percutaneous drainage due to anastomosis or staple line leakage after sleeve gastrectomy due to obesity in the interventional unit of our hospital between February 2015 and September 2020.
Results: A total of 48 drainage catheters were inserted in 30 patients (8 females and 22 males), aged 19–71 years (mean 51.24), under the guidance of CBCT fluoroscopy. Drainage was completed in a single session with one catheter in 13 (43.3%) patients. In 17 (56.7%) patients, the procedure was completed with two or more catheterizations in more than one session due to different leakage locations and subsequent occlusion or dislocation of the catheter. Inflammatory parameters and symptoms related to leakage regressed in 29 (94%) patients within 48–72 hours with clinical improvement. The success rate of percutaneous drainage was 100% without any complications.
Conclusion: Anastomosis, or staple line leakage, is one of the most serious life-threatening complications that can be seen following laparoscopic sleeve gastrectomy. CBCT fluoroscopy-guided drainage is a safe, highly effective, and minimally invasive treatment option that has a low risk of complications. This technique can facilitate the treatment of postoperative collections with alternative treatment methods.
Anahtar Kelimeler
Cone-beam computerized tomography, drainage, fluoroscopy, gastrectomy
Destekleyen Kurum
This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors
Teşekkür
Dear Editor,
We would like to submit our enclosed manuscript entitled “Cone-Beam CT Fluoroscopy-Guided Percutaneous Drainage for the Treatment of Leakage After Laparoscopic Sleeve Gastrectomy” to publish in Anatolian Clinic the Journal of Medical Science.
Thank you very much for your interest and we are looking forward to hearing from you very soon.
Sincerely yours,
Kaynakça
- Frühbeck G. Bariatric and metabolic surgery: a shift in eligibility and success criteria. Nat Rev Endocrinol. 2015;11(8):465-77.
- Baltacı D. Ünalacak M. Birinci basamakta obezite tedavisi. Turkiye Klinikleri J Fam Med-Special Topics. 2015;6(3):96-102.
- Jamal MH, Aminian A. Bariatric surgery: Is it a safe treatment modality? Kuwait Med J. 2015;47(3):193-200.
- Ruban A, Stoenchev K, Ashrafian H, Teare J. Current treatments for obesity. Clin Med (Lond). 2019;19(3):205-12.
- Suraweera D, Saab EG, Choi G, Saab S. Bariatric Surgery and Liver Transplantation. Gastroenterol Hepatol (N Y). 2017;13(3):170-5.
- Winfield RD, Reese S, Bochicchio K, Mazuski JE, Bochicchio GV. Obesity and the Risk for Surgical Site Infection in Abdominal Surgery. Am Surg. 2016;82(4):331-6.
- Tjeertes EK, Hoeks SE, Beks SB, Valentijn TM, Hoofwijk AG, Stolker RJ. Obesity--a risk factor for postoperative complications in general surgery?. BMC Anesthesiol. 2015;15:112.
- Slim R, Smayra T, Chakhtoura G, Noun R. Endoscopic stenting of gastric staple line leak following sleeve gastrectomy. Obes Surg. 2013;23(11):1942-5.
- Simon F, Siciliano I, Gillet A, Castel B, Coffin B, Msika S. Gastric leak after laparoscopic sleeve gastrectomy: early covered self-expandable stent reduces healing time. Obes Surg. 2013;23(5):687-2.
- Shehab HM, Hakky SM, Gawdat KA. An Endoscopic Strategy Combining Mega Stents and Over-The-Scope Clips for the Management of Post-Bariatric Surgery Leaks and Fistulas (with video). Obes Surg. 2016;26(5):941-8.