Year 2020 Vol. 28 No 5




E.A.Vagner Perm State Medical University 1,
Perm Regional Clinical Hospitall 2, Perm,
The Russian Federation

Over the last decade laparoscopic sleeve gastrectomy has taken a leading position among bariatric operations. The failure of the mechanical suture of the gastric stump is considered to be the most severe complication in the postoperative period. The purpose of this report is to demonstrate a case of successful treatment of the late leakage of the gastric sleeve staple line with interventional methods. A 56-year-old patient with a body mass index of 50 underwent laparoscopic sleeve gastrectomy using a 36 Fr calibration probe. Check of the mechanical staple line for leak-tightness was carried out by the introduction of 150 ml of liquid colored methylene blue. On the 12th day after the operation computed tomography revealed suture incompetence. X-ray stomach examination was conducted twice, it was impossible to detect swelling of the contrast agent. To close the site of leakage, a fully covered self-expanding stent was installed endoscopically, and the zone of abscess was drained by relaparoscopy. When the stent removed below the cardiac pulp, it was reinstalled. After 4 weeks the fistula closed, and no swelling was detected on CT. The stent was removed and the patient was discharged from hospital in satisfactory condition.

Keywords: laparoscopic sleeve gastrectomy, leakage, self-expanding stent
p. 591-596 of the original issue
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Address for correspondence:
614000, Russian Federation,
Perm, Kuybyshev str., 43,
E.A. Vagner Perm State Medical University,
the Surgery Department with the Course
of the Cardiovascular Surgery
and Invasive Cardiology,
tel.: +7902 83 569 65,
Kotelnikova Ludmila P.
Information about the authors:
Kotelnikova Liudmila P., MD, Professor, Head of the Surgery Department with the Course of the Cardiovascular Surgery and Invasive Cardiology, E.A.Vagner Perm State Medical University, Perm, Russian Federation.
Fedachuk Alexey N., PhD, Surgeon of the 1st Surgical Unit, Perm Regional Clinical Hospital, Perm, Russian Federation.
Sharev Andrey V., Endoscopist, Head of the Endoscopy Unit, Perm Regional Clinical Hospital, Perm, Russian Federation
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