LEAKAGE IN BARIATRIC SURGERY: A 10-YEAR EXPERIENCE

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Alexandria University

Abstract

Background: Leakage is a dreaded complication of bariatric surgery. The aim of this study was to describe 
the clinical presentation and outcomes of treatment in patients who develop gastrointestinal leaks after 
bariatric surgery.
Methods: Retrospective review of 632 consecutive bariatric surgical procedures performed from 1999-2009 
in Alexandria University Hospital, Egypt.
Results: leakage occurred in 10 patients. Symptoms and signs included tachycardia, fever, tachypnea, left 
shoulder pain, abdominal pain, chest pain, and/or change in the nature of the drain effluent. The average 
time to diagnosis was 3.9±2.6 days. Six leaks occurred after laparoscopic vertical banded gastroplasty (6.3%), 
2 after laparoscopic gastric bypass (3.6%), one after open gastric bypass (2.3%), and 1 after laparoscopic 
sleeve gastrectomy (2.4%). The most common leak location was at the esophagogastric junction (70%). Four 
patients (40%) required reoperations. A percutaneous abdominal drainage was placed in five patients (50%). 
In 2 patients (20%), the prophylactic drain was maintained in situ till cessation of leakage. Two patients 
(20%) died. Mean hospital length of stay was 13.9±7.8 days.
Conclusions: Leakage is a serious complication after bariatric surgery with a significant mortality. Patients 
with signs of sepsis or hemodynamic instability require emergent exploration. Leaks that are more insidious 
may be treated successfully with percutaneous drainage or maintenance of prophylactic drains.

Keywords

The Egyptian Journal of Surgery
Volume 30, Issue 4
October 2011
Pages 163-168

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