Department of Gastrointestinal Surgery, Vaasa Central Hospital, Hietalahdenkatu 2-4, 65130, Vasa, Finland,
Obes Surg. 2013 Oct;23(10):1692-7. doi: 10.1007/s11695-013-1048-2.
Laparoscopic Roux-en-Y gastric bypass (LRYGB) is the most commonly performed bariatric/metabolic operation in Europe. Different treatment options for the management of gastrojejunal (GJ) leaks following LRYGB have been published. We looked at our own experience with GJ leaks after 645 consecutive LRYGB operations and reviewed the literature with focus on the use of fibrin sealant and self-expandable metal stents as treatment options. Patient data were prospectively collected in the hospital's database for bariatric patients. All patients with confirmed GJ leaks were reviewed. Patients with GJ leaks were actively treated by a combination of laparoscopic drainage and endoscopic fibrin sealant injections and/or stenting. Six patients (0.93%) have been treated for GJ leaks. All leaks were successfully treated and there was no leak-related mortality. The mean (SD) time for closure of the leaks and length of hospital stay was 19.5 days (6.2) and 23.2 days (3.7). The literature concerning endoscopic treatment options in case of GJ leaks following LRYGB operations is scarce and inconclusive. Immediate and active treatment with a combination of operative and endoscopic treatment options, rather than choosing only one treatment over another, may enhance the recovery process.
腹腔镜 Roux-en-Y 胃旁路术（LRYGB）是欧洲最常进行的减肥/代谢手术。已经发表了多种不同的治疗方法来处理 LRYGB 后发生的胃空肠（GJ）漏。我们回顾了我们在 645 例连续 LRYGB 手术后发生 GJ 漏的经验，并重点研究了纤维蛋白胶和自膨式金属支架的使用作为治疗选择的文献。患者数据在医院的减肥患者数据库中进行前瞻性收集。所有确诊为 GJ 漏的患者都进行了回顾。GJ 漏的患者通过腹腔镜引流和内镜纤维蛋白胶注射和/或支架置入的联合积极治疗。有 6 名患者（0.93%）接受了 GJ 漏的治疗。所有漏均成功治愈，无漏相关死亡。漏的闭合时间和住院时间的平均值（SD）分别为 19.5 天（6.2）和 23.2 天（3.7）。关于 LRYGB 手术后 GJ 漏的内镜治疗选择的文献很少且没有定论。立即采用手术和内镜治疗选择相结合的积极治疗，而不是只选择一种治疗方法，可能会促进康复过程。
