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Use of Self-Expandable Metal Stents in the Treatment of Leaks Complicating Laparoscopic Sleeve Gastrectomy: A Cohort Study

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Abstract

Background

Use of a self-expandable metal stent (SEMS) as an initial intervention for leaks after laparoscopic sleeve gastrectomy (LSG) has increased. We assessed the efficacy and safety of SEMS in the treatment of post-LSG leaks, and the determinants of repeated rounds of stenting.

Methods

A retrospective chart review was conducted at a university hospital in Saudi Arabia. The study included patients who developed leaks after undergoing LSG between October 2011 and April 2016.

Results

Sixty-four patients (mean age, 35.69 ± 10.71 years) were included; 55% were males. The mean estimated size of the defect was 1.18 cm; partially covered SEMS and fully covered SEMS were used as the initial stents in 82.81 and 17.19% patients, respectively. One round of stenting was required in most patients (82.81%), two rounds in 10.94%, and three rounds in 6.25%. Clinical success was achieved in 93.75% patients, including 78.13% in the first round, 89.06% by the second round, and 93.75% by the third round. A higher proportion of patients who needed one round of stenting received a partially covered SEMS compared to those who needed two rounds (91.11 vs. 42.86%, p < 0.01). Additionally, the rate of migration in patients who underwent two rounds was higher than that in patients who underwent one round (42.86 vs. 5.26%, p < 0.01) of stenting.

Conclusion

Repeated stenting for leaks after LSG is an effective and safe intervention. The efficacy of partially covered SEMS appears superior to that of the fully covered SEMS.

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Funding

The authors extend their sincere appreciation to the Deanship of Scientific Research at King Saud University for its funding of this research through the Research Group Project number RGP-279.

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Authors and Affiliations

  1. Division of Gastroenterology, King Khalid University Hospital, King Saud University, P.O. Box 2925(59), Riyadh, 11461, Saudi Arabia

    Majid Abdularahman Almadi, Othman Alharbi, Nahla Azzam, Mohanned Eltayeb, Salem Thaniah & Abdulrahman Aljebreen

  2. Division of Gastroenterology, The McGill University Health Center, Montreal General Hospital, McGill University, Montreal, Canada

    Majid Abdularahman Almadi

  3. Division of Surgery, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

    Fahad Bamihriz & Abdullah Aldohayan

  4. Division of Medicine, King Khalid University Hospital, King Saud University, Riyadh, Saudi Arabia

    Ahmed Aljammaz

Authors
  1. Majid Abdularahman Almadi
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  4. Nahla Azzam
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  7. Salem Thaniah
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  8. Abdullah Aldohayan
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  9. Abdulrahman Aljebreen
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Contributions

Majid A Almadi: Analysis of the data, writing, drafting, revising the article for important intellectual content, and final approval of the version to be published.

Fahad Bamihriz, Abdullah Aldohayan: Revising the article critically for important intellectual content and final approval of the version to be published.

Mohanned Eltayeb, Salem Thaniah, Ahmed Aljammaz, Othman Alharbi, Nahla Azzam, Abdulrahman Aljebreen: Acquisition of data, revising the article critically for important intellectual content, and final approval of the version to be published.

Corresponding author

Correspondence to Majid Abdularahman Almadi.

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Ethical Approval Statement

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed Consent Statement

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no competing interests.

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Almadi, M.A., Bamihriz, F., Alharbi, O. et al. Use of Self-Expandable Metal Stents in the Treatment of Leaks Complicating Laparoscopic Sleeve Gastrectomy: A Cohort Study. OBES SURG 28, 1562–1570 (2018). https://doi.org/10.1007/s11695-017-3054-2

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