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World J Gastroenterol. Oct 14, 2014; 20(38): 13904-13910
Published online Oct 14, 2014. doi: 10.3748/wjg.v20.i38.13904
Gastric leaks post sleeve gastrectomy: Review of its prevention and management
Antoine Abou Rached, Melkart Basile, Hicham El Masri
Antoine Abou Rached, Department of Internal Medicine, Gastroenterology Division, Lebanese University, Hadath, Beirut 2903 1308, Lebanon
Melkart Basile, Hicham El Masri, Department of General Surgery, Lebanese University, Hadath, Beirut 2903 1308, Lebanon
Author contributions: Abou Rached A contributed in the conception and design; Basile M and El Masri H performed research and drafted the article; All authors revised the article for important intellectual content; Abou Rached A revised it for final approval of the version to be published.
Correspondence to: Antoine Abou Rached, MD, MBAIP, Department of Internal Medicine, Gastroenterology Division, Lebanese University, Hadath, Campus, PO Box #3, Hadath, Beirut 2903 1308, Lebanon. abourachedantoine@gmail.com
Telephone: +961-5-451100 Fax: +961-5-455131
Received: February 24, 2014
Revised: May 21, 2014
Accepted: June 14, 2014
Published online: October 14, 2014
Core Tip

Core tip: Gastric leak is one of the most feared complications after a sleeve gastrectomy. Routine oversewing of the staple line decreases the hemorrhagic complications but may not decrease the leak rate. Fever and tachycardia are the two most important clinical factors in the detection of gastric leaks and should never be neglected. The treatment modality should be based on the clinical status of the patient and the timing of the leak. Complete endoscopic approach via natural orifices transluminal endoscopic surgery, diversion using a stent and closure with glue or clips is a reasonable option in selected patients and specialized centers.