Saglam Kutay, Aktas Aydin, Gundogan Ersin, Ertugrul Ismail, Tardu Ali, Karagul Servet, Kirmizi Serdar, Sumer Fatih, Ersan Veysel, Kayaalp Cuneyt
Department of Surgery, Inonu University, Malatya, Turkey.
Obes Surg. 2017 Nov;27(11):3061-3063. doi: 10.1007/s11695-017-2898-9.
Management of early sleeve gastrectomy leak remains challenging. The recommended approach is endoscopic stenting and abdominal drainage. Conversion to a Roux-en-Y gastric bypass (RYGB) is a common procedure used for late fistulas with distal obstruction. Here, we have presented three cases of early staple line leaks treated by conversion to RYGB. These patients had uncontrolled abdominal infections despite intensive medical treatments, and surgery was elected for abdominal drainage as well as to control the source of sepsis. All the patients were discharged without problems, and successful weight loss processes continued. Conversion to RYGB of a sleeve gastrectomy leak in an acute setting can be a feasible method in the case of inevitable surgical drainage for abdominal sepsis.
早期袖状胃切除术漏的处理仍然具有挑战性。推荐的方法是内镜支架置入和腹腔引流。转为Roux-en-Y胃旁路术（RYGB）是用于治疗伴有远端梗阻的晚期瘘的常用手术。在此，我们介绍了3例通过转为RYGB治疗的早期吻合口漏病例。尽管进行了强化药物治疗，这些患者的腹腔感染仍无法控制，因此选择手术进行腹腔引流以及控制脓毒症的源头。所有患者均顺利出院，体重继续成功减轻。在因腹腔脓毒症不可避免地需要进行手术引流的情况下，急性情况下将袖状胃切除术漏转为RYGB可能是一种可行的方法。
