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How do you manage a gastric sleeve leak?

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A gastric sleeve leak can be fatal, but one way that doctors manage it is by inserting a gastroscopic stent to support the sleeve and restore it to normal function. While removing the stent is still tricky, improvements in the procedure reduce patient morbidity significantly, according to Bariatric Times.

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Researchers have found that approximately 9 percent of gastric sleeve recipients encounter leaks after the process, with an even higher percentage occurring after a revision procedure. Most of these leaks are near the point where the esophagus meets the stomach. Use of the stent resolved leak problems immediately in approximately two-thirds of the 29 patients who encountered leaks in their gastric sleeves, which were installed by St. Blasius Hospital Dendermonde and St. Pierre Hospital in Brussels, Belgium. In all of the patients, the stents came out uneventfully. However, 10 of the 29 needed a second stent procedure to resolve the gastric sleeve completely, and five of those encountered success after the second stent, notes Bariatric Times.

Leakage is one of the primary causes of deaths resulting from bariatric surgery. With the gastric sleeve, the line of staples is long, and the internal pressure is higher. Researchers claim that the improvement from the stent comes from the ability to provide direct feeding rather than intravenous nutrition, resulting in a shorter time in the hospital. Complications with the stent involve movement while in the sleeve and difficulty with removal, but inserting a plastic stent inside the lumen of the metal stent a couple of weeks ahead of extraction appears to solve that issue in most cases, as stated by Bariatric Times.

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