Background: Leaks are the major complication associated with laparoscopic sleeve gastrectomy.
Objective: The study aimed to assess the efficacy and safety of specifically designed large covered
metal stents for the management of post-laparoscopic sleeve gastrectomy leaks.
Methods: Prospectively collected databases from three Italian Endoscopy Units were reviewed.
The primary outcome of the study was to evaluate the clinical success of stents placement, defined
as complete resolution of clinical and laboratory signs of sepsis with radiological evidence of leak
closure. Secondary outcomes were stent-related adverse events and mortality.
Results: Twenty-one patients (67% females, mean age 45 years) were included in the study and a
total of 26 stents were placed. Technical success of stent placement was achieved in all cases
(100%). Clinical success was observed in 85.5% of patients. Stent-related adverse events occurred
in 9 patients (43%), with stent migration as the most frequent complication (33%). Adverse events
were more frequently observed in patients who had undergone bariatric surgery prior to laparoscopic
sleeve gastrectomy compared to patients without previous surgery (83% et al. 27%, p=0.018).
Conclusion: The placement of specifically designed covered metal stents appears to be an effective
and safe therapeutic approach for post-laparoscopic sleeve gastrectomy leaks. Stent migration
can be a frequent complication.