Montuori Mauro, Benavoli Domenico, D'Ugo Stefano, Di Benedetto Luca, Bianciardi Emanuela, Gaspari Achille L, Gentileschi Paolo
Bariatric Surgery Unit, Department of Experimental Medicine and Surgery, University of Rome Tor Vergata, 00133 Rome, Italy.
Psychiatry Unit, Department of Systems Medicine, University of Rome Tor Vergata, 00133 Rome, Italy.
J Obes. 2017;2017:4703236. doi: 10.1155/2017/4703236. Epub 2017 Feb 2.
. Aim of the study was trying to draw a final flow chart for the management of gastric leaks after laparoscopic sleeve gastrectomy, based on the review of our cases over 10 years' experience. . We retrospectively reviewed all patients who underwent LSG as a primary operation at the Bariatric Unit of Tor Vergata University Hospital in Rome from 2007 to 2015. . Patients included in the study were 418. There were 6 staple line leaks (1.44%). All patients with diagnosis of a leak were initially discharged home in good clinical conditions and then returned to A&E because of the complication. The mean interval between surgery and readmission for leak was 13,4 days (range 6-34 days, SD ± 11.85). We recorded one death (16.67%) due to sepsis. The remaining five cases were successfully treated with a mean healing time of the gastric leak of 55,5 days (range 26-83 days; SD ± 25.44). . Choosing the proper treatment depends on clinical stability and on the presence or not of collected abscess. Our treatment protocol showed being associated with low complication rate and minor discomfort to the patients, reducing the need for more invasive procedures.
本研究的目的是基于对我们10年经验病例的回顾,绘制一份腹腔镜袖状胃切除术后胃漏管理的最终流程图。
我们回顾性分析了2007年至2015年在罗马托尔韦尔加塔大学医院肥胖症治疗科接受初次腹腔镜袖状胃切除术的所有患者。
纳入研究的患者有418例。有6例吻合口漏(1.44%)。所有诊断为漏的患者最初均在临床状况良好的情况下出院,随后因并发症返回急诊室。手术至因漏再次入院的平均间隔时间为13.4天(范围6 - 34天,标准差±11.85)。我们记录了1例因败血症死亡(16.67%)。其余5例成功治愈,胃漏平均愈合时间为55.5天(范围26 - 83天;标准差±25.44)。
选择合适的治疗方法取决于临床稳定性以及是否存在收集到的脓肿。我们的治疗方案显示并发症发生率低,患者不适轻微,减少了对更具侵入性手术的需求。