Leaks in GASTRIC BYPASS AND SLEEVE GASTRECTOMY are among the worst and maybe the most fearful complications in bariatric surgery.
After the initial diagnosis and sepsis stabilization an endoscopic therapeutic plan should be assigned.
From the healing perspective, it seems like the two procedures has different outcomes in term of leakage.
On the gastric bypass most of the leaks heals up to 30 days and a conservative approach is advisable.
After this period and endoscopy should be performed having in mind the observation of he pouch itself with close attention to the staple line at were the greater curvature was stapled and transected, the gastro-jejunostomy (GJ) and the alimentary limb.
The master statement that a to treat a digestive leak the obstructions (stenosis) have to be removed always applies and if the endoscope do
not pass trough the GJ, dilation should be done as first move. Traditional
therapeutic endoscopy like biological glue, clips and meshes should be used t http://amplify.com/u/a1cf6b