Treatment of Persistent Leaks After Laparoscopic Sleeve Gastrectomy with the Simultaneous Over-the-Scope Clip (OTSC) and Mega Stent Strategy

Abstract

Persistent staple-line leak is a challenging complication after laparoscopic sleeve gastrectomy (LSG). The over-the-scope clip (OTSC) (Ovesco®, Tübingen, Germany) and the Mega stent (Taewoong medical, Seoul, South Korea) recently gained encouraging results in the management of early leaks. This is a retrospective series (n = 8) focused on the management of persistent leaks after LSG with the simultaneous OTSC/Mega stent strategy. Seven patients underwent primary LSG. The median time from LSG to OTSC/Mega stent treatment was 48.5 days (range 28–63), and the median defect size was 9.5 mm (range 7–12). The median time to clear liquid diet, hospital length of stay, and overall treatment time were 4 days (range 2–5), 31 days (range 26–57), and 47 days (range 34–107), respectively. Overall success rate was 87.5%. Postoperative morbidity was 25%. The mean follow-up time was 18 months (range 3–24) with no fistula recurrence.