Different parameter of the detection and management of sleeve gastrectomy leakage; our expert bariatric clinic results

Abstract

Introduction: Laparoscopic sleeve gastrectomy is being performed with increasing frequency for treatment of obesity. In this study, the aim is to explain the management of sleeve gastrectomy leakage. Material and Methods: A total of 1505 patients on whom we have performed sleeve gastrectomy as a standard treatment for morbid obesity in the last 10 years were included in this study. Thirty-one of these patients with staple line leakage were included. Age, gender, body mass index and comorbidity rates as well as procalcitonin and C-reactive protein levels of the patients were recorded as data. Results: Of the total 31 patients, 12 (0.7973%) were from our center, and 19 were referred from an external center. The mean age of the patients was 34.46 years (range 17-62 years). The average leak detection time was 21.13 days. All of the 31 patients were stenting after the postoperative period. The mean procalcitonin level of the patients with no leakage was 0.4 ng/mL, whereas the level of the patients with leakage was 4.59 ng/mL. Mean C-reactive protein levels of the patients without leakage was 15.84 mg/L, while the level of the patients with leakage was 251.034 mg/L. The mean body mass index was 42.52. The mean hospital stay was 26.34 days (range 6-61 days). Discussion: Our study demonstrates that proper treatment and early detection of leakage are important. Early detection of C-reactive protein and procalcitonin after sleeve gastrectomy is a warning sign to help detect a leakage, which is important to patient’s treatment.

Keywords

• Sleeve gastrectomy
• Leakage
• Procalcitonin
• C-reactive protein

Tüp mide ameliyatı kaçağının tespiti ve yönetiminin farklı parametreleri; bariatrik kliniğimizin sonuçları

Öz

Giriş: Obezite tedavisinde laparoskopik sleeve gastrektomi giderek artan sıklıkta uygulanmaktadır. Bu çalışmada sleeve gastrektomi kaçağının yönetimini açıklamak amaçlanmıştır. Gereç ve Yöntemler: Son 10 yılda morbid obezite için standart tedavi olarak sleeve gastrektomi uyguladığımız toplam 1505 hasta çalışmaya dahil edildi. Bu hastalardan stapler hattı kaçağı olan 31 hasta çalışmaya dahil edildi. Hastaların yaş, cinsiyet, vücut kitle indeksi, eşlik eden hastalık oranları ile prokalsitonin ve C-reaktif protein düzeyleri veri olarak kaydedildi. Sonuç Toplam 31 hastanın 12'si (%0,7973) merkezimizden, 19'u ise dış merkezden sevk edilmişti. Hastaların ortalama yaşı 34,46 yıl (aralığı 17-62 yıl) idi. Ortalama kaçak tespit süresi 21,13 gündü. 31 hastanın tamamına postoperatif dönemde stent takıldı. Sızıntısı olmayan hastaların ortalama prokalsitonin seviyesi 0,4 ng/mL iken, sızıntısı olan hastaların seviyesi 4,59 ng/mL olarak bulundu. Sızıntısı olmayan hastaların ortalama C-reaktif protein seviyesi 15,84 mg/L iken, sızıntısı olan hastaların seviyesi 251,034 mg/L olarak bulundu. Ortalama vücut kitle indeksi 42,52 idi. Ortalama hastanede kalış süresi 26,34 gündü (aralığı 6-61 gün). Tartışma: Çalışmamız, sızıntının uygun tedavisinin ve erken tespitinin önemli olduğunu göstermektedir. Tüp mide ameliyatından sonra C-reaktif protein ve prokalsitoninin erken tespiti, hastanın tedavisi için önemli olan sızıntının tespit edilmesine yardımcı olan bir uyarı işaretidir.

Anahtar Kelimeler

• Tüp mide
• kaçak
• prokalsitonin
• C- reaktif protein

Kaynakça

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