Prevalence of Anastomotic Leaks and Diagnostic Methods in Sleeve Gastrectomy

Abstract

Background:

Staple line leak is a major complication of sleeve gastrectomy. Intraoperative methylene blue and computer tomography (CT) scan tests are routinely used to evaluate the leakage; however, the effectiveness of these tests is controversial.

Materials and Methods:

In this retrospective study, all patients who underwent sleeve gastrectomy from March 2016 to February 2018 were included. The administration of intraoperative leak testing and the type of test (CT scan, methylene blue, and clinical evaluations) were based on surgeon decision. The primary outcome was the leakage rate between the leak test (LT) and nonleak test groups.

Results:

Routine intraoperative LTs were performed in 328 (20.9%) out of 1566 cases, whereas 1238 (79.1%) cases did not have LTs. The intraoperative results were negative in the LT group. Eight patients (2.4%) developed leaks during the postoperative period. In addition, leaks presented at a mean of 7.5 days postoperatively (range: 1–14 days). In seven patients, leak was in the gastroesophageal junction and in one patient, it was in the greater curvature.

Conclusion:

Intraoperative leak testing and postoperative CT scan are not effective in the diagnosis of the leakage caused by laparoscopic sleeve gastrectomy and are not predictive of the later development of staple line leak.