Sleeve gastrectomy (SG) is now a widely performed bariatric procedure; however, staple‐line leaks remain a challenging adverse event. This study evaluates leak rates, management strategies, and weight loss outcomes after ambulatory laparoscopic SG.
567 consecutive patients were analyzed with severe obesity who underwent outpatient laparoscopic SG between 2019 and 2022 at a tertiary hospital. Among these, 20 patients with endoscopically confirmed staple‐line leaks were compared to the remaining 547 patients without leaks (controls). Demographic data, surgical details, leak time to clinical presentation, management strategies, and longitudinal weight loss metrics (assessed at 3, 6, 12, 24, and 36 months) were evaluated and analyzed using appropriate statistical tests.
The overall leak rate was 3.52% (n = 20). Patients in the leak group had significantly lower baseline median body mass index (BMI) and excess body weight (EBW) compared to controls. The median time from initial surgery to endoscopic diagnosis was 10 (1 – 49) days with all leaks located proximally. Median fistula orifice size was 4 (2 – 20) mm with 85% (n = 17) being small defects (< 10 mm diameter). Endoscopic management achieved closure of fistula orifice in 100% (n = 20) of patients with a median leak closure time of 10 (2 – 22) weeks with repeat sessions when needed. Weight loss outcomes in patients with leaks were significantly inferior at 12, 24, and 36 months compared to controls.
Outpatient SG carries a low but significant risk of leaks. Early detection and endoscopic treatment yield effective leak management while maintaining acceptable long‑term weight loss outcomes. Further prospective studies are warranted.
doi: 10.17756/jocd.2025-054
Citation: Correia VP, Gomes OC, Lalanda R, Marques P, Nogueira F, et al. 2025. Outpatient Sleeve Gastrectomy Leak Rates and Their Management. J Obes Chronic Dis 9(1): 22-30.
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