Gipe Jordan, Agathis Alexandra Z, Nguyen S Q
Department of Surgery, Mount Sinai Hospital, New York, NY, USA.
Clin Exp Gastroenterol. 2025 Jan 7;18:1-9. doi: 10.2147/CEG.S461534. eCollection 2025.
Postoperative leaks after sleeve gastrectomy are a troublesome complication that occur in 0.7-5.3% of cases depending on the referenced source. These complications cause significant morbidity for patients requiring prolonged hospitalizations, nutritional support, intravenous antibiotics, and at times additional operations and procedures that risk further downstream complications. The patient presentation varies from relatively benign with minimal or no symptomatology, to the acutely ill with life-threatening sepsis. The management of gastric leak is dependent on a multitude of factors, including the initial presentation as well the surgeon's experience and preference. Here, we will summarize the current literature and discuss the different options that exist for the management of gastric leaks after sleeve gastrectomy including laparoscopic lavage, endoscopic stenting, endoscopic pigtail catheters, endoscopic vacuum therapy, and salvage surgical operations such as fistula jejunostomy and total gastrectomy. The aim is to provide a source for surgeons to reference when they encounter this disease pathology and to shed light on a daunting challenge for the modern bariatric surgeon.
根据参考资料来源，袖状胃切除术后的术后渗漏是一种麻烦的并发症，发生率在0.7%-5.3%之间。这些并发症会给患者带来严重的发病情况，需要延长住院时间、提供营养支持、静脉使用抗生素，有时还需要进行额外的手术和操作，这会带来进一步的下游并发症风险。患者的表现各不相同，从相对良性、症状轻微或无症状，到病情危急、伴有危及生命的败血症。胃渗漏的处理取决于多种因素，包括初始表现以及外科医生的经验和偏好。在此，我们将总结当前的文献，并讨论袖状胃切除术后胃渗漏处理的不同选择，包括腹腔镜灌洗、内镜支架置入、内镜猪尾导管、内镜真空治疗，以及挽救性外科手术，如瘘管空肠造口术和全胃切除术。目的是为外科医生在遇到这种疾病病理情况时提供一个参考来源，并阐明现代减肥外科医生面临的艰巨挑战。
