Retrospective Analysis of the Management of Leakage After Sleeve Gastrectomy in the Department of General Surgery, Ain Shams University

Background Laparoscopic sleeve gastrectomy is the most commonly performed bariatric surgery, the most dreadful complication is leakage. Effective management of post LSG leakage requires a multidisciplinary approach, involving the patient, surgeon, nutritionist, and other healthcare professionals. Patients should be closely monitored after surgery to detect any complications early and prevent further health problems. Patients should also follow all instructions regarding diet, physical activity, and medication use, and attend all follow-up appointments. However, LSG can be associated with complications that can be fatal. Post LSG leakage can be effectively treated with proper management. There are different management modalities of post LSG leakage. In El Demerdash hospital post LSG leakage is treated by conservative managements, radiological intervention, endoscopic management, laparoscopic management and surgical interventions as redo or conversion of type of operation. Early detection and appropriate surgical management of post LSG leakage are crucial to prevent long-term patient morbidity and mortality. Objective To determine the lines of management and outcomes of leakage after sleeve gastrectomy. Methods This was a retrospective and prospective Study that was conducted at General surgery department, Ain Shams University Hospitals from January 2024 to September 2024 on 23 patients who underwent LSG and developed postoperative leakage in the period from January 2019 to January 2024. Results The results of our present study as follows: Median leakage time was 10 days. Acute leakage (<1 week) occurred in 8.7% of patients. Intermediate leakage (1 to 3 weeks) occurred in 60.9%, and late leakage (>3 weeks) occurred in 30.4%. Only one patient (4.35%) had the HR, temperature, and RR within normal ranges. Elevated values of HR, temperature, and RR were recorded in 91.3%, 95.6%, and 91.3%, respectively. Group I had 0% complications. Group II patients had stent migration in 21.42% of cases and persistent vomiting in 35.71% of patients, respectively. Group III patients had bleeding in 28.57%, respiratory tract infection in 14.29%, and wound infection in 14.29%. 2 patients from Group III died from sepsis (8.69%). Conclusion Leakage after LSG is a dreadful complication. Clinical and laboratory data should be examined very carefully as they are useful markers for the detection of leakage process. Multiple management plans are available with varying success and adverse outcome profiles.