Long-Term Outcomes of Patients with Staple Line Leaks Following Sleeve Gastrectomy

Obes Surg. 2024 Jul;34(7):2523-2529. doi: 10.1007/s11695-024-07307-0. Epub 2024 May 30.

Abstract

Purpose: The long-term outcomes of patients with staple line leaks (SLL) after SG are under-reported. The purpose of this study is to evaluate the long-term outcomes of patients with SLL after SG.

Materials and methods: A retrospective analysis of a maintained patient registry of patients undergoing SG between January 2012 and December 2020 in a single bariatric center was analyzed and included patients with SLL. Outcomes were compared to a group without SLL.

Results: During this period, 1985 patients underwent SG of which 61 patients (3.1%) developed leak. 26 patients (1.3%) had overt SLL and the rest had organ space infection around the staple line. The mean age and body mass index (BMI) were 39.8 ± 11.3 and 41.5 ± 4.7, respectively. 7 patients (11.4%) underwent concomitant surgery and 12 patients (19.7%) had intraoperative complications. Leak was complicated by Clavien-Dindo ≥ 3 in 31 patients (50.8%). Reoperation rate was 27.8% (n = 17). ≥ 2 interventions were required in 26% of patients (n = 16). Two patients died during hospitalization due to septic complications. Long-term follow-up of median 121 months was available in 78% of the cohort (n = 48). The median total weight loss and BMI were 27% and 30.1 kg/m2, respectively. Weight loss outcomes were higher in comparison to patients without SLL. Seven patients (14.6%) underwent SG revision. All associated medical problems improved during follow-up except for gastroesophageal reflux which was found in 50% of cohort.

Conclusion: Long-term outcomes of SG patients with SLL are satisfactory in terms of weight loss, resolution of comorbidities, and requirement for surgical revision.

Keywords: Bariatric surgery; Leaks; Long-term outcomes; Severe obesity; Sleeve Gastrectomy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Anastomotic Leak / epidemiology
  • Anastomotic Leak / etiology
  • Anastomotic Leak / therapy
  • Bariatric Surgery* / adverse effects
  • Bariatric Surgery* / statistics & numerical data
  • Comorbidity
  • Female
  • Gastrectomy* / adverse effects
  • Gastrectomy* / statistics & numerical data
  • Humans
  • Israel / epidemiology
  • Male
  • Middle Aged
  • Obesity* / surgery
  • Retrospective Studies
  • Surgical Stapling* / adverse effects
  • Surgical Wound Infection* / etiology
  • Surgical Wound Infection* / mortality
  • Weight Loss