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Cirujano general

Print version ISSN 1405-0099


ROMERO MEJIA, César  and  PAIPILLA MONROY, Omar. Fistula after laparoscopic sleeve gastrectomy. Cir. gen [online]. 2016, vol.38, n.3, pp.158-161.  Epub Mar 31, 2020. ISSN 1405-0099.

We present four patients with gastric leak after sleeve gastrectomy for the treatment of morbid obesity. All of them came from another hospital and were admitted an average of 10 days after surgery. The perforation was located at the esophagogastric junction and measured two centimeters. Every patient was operated upon four times, with a hospital stay of 20 days. Three patients closed the fistula and one requested his transfer to another hospital in Mexico City. We review a clinical-therapeutic classification for the management of these lesions and attempt to explain the mechanisms of production and the way to treat them. Lesions are classified in three categories: early, intermediate and late. All of our patients had late leaks. The nature of the lesion was described as thermal tissue damage, the creation of a high-pressure tube adjacent to two sphincters and the empirical use of different sizes of staples. Finally, we review the new forms of treatment for late post sleeve gastrectomy leaks.

Keywords : Laparoscopic sleeve gastrectomy; leaks after sleeve gastrectomy; late fistula after sleeve gastrectomy.

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