Successful management of refractory staple line leakage at the esophagogastric junction after a sleeve gastrectomy using the HANAROSTENT

Obes Surg. 2010 Apr;20(4):530-4. doi: 10.1007/s11695-009-9976-6. Epub 2009 Oct 16.

Abstract

The esophagogastric junction (EGJ) is a potential site of leakage after a sleeve gastrectomy which is usually difficult to treat conservatively. Two patients underwent a laparoscopic sleeve gastrectomy. A subphrenic abscess due to a staple line leakage was detected by CT at 3 weeks and 10 days after the operation, respectively. The abscess was drained laparoscopically. Intractable leakage required several endoscopic treatments, including clipping and sealing. However, a persisting fistula was found on radiographic studies. A covered self-expandable and retrievable stent (HANAROSTENT) was finally placed over the leakage site at 15 and 6 weeks after the reoperation, respectively. Oral intake was achieved from poststent day 1, and they were discharged 2 weeks after stenting. Three months later, the stent was endoscopically removed and the leakage was successfully sealed. The HANAROSTENT is therefore considered to be a safe and effective therapeutic option for the management of staple line leakage at the EGJ.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Esophagogastric Junction
  • Female
  • Gastrectomy / adverse effects*
  • Humans
  • Male
  • Obesity, Morbid / surgery*
  • Surgical Stapling / adverse effects*
  • Surgical Wound Dehiscence / etiology
  • Surgical Wound Dehiscence / surgery*