It is one of the most serious complications facing the surgeon and the patient who undergoes obesity operations in general, and sleeve gastrectomy is one of these operations.. Its global incidence ranges from 1-3%, but this percentage decreases significantly when the surgery is performed in expert hands and well-equipped centers.
The most important point in the successful treatment of this problem is the early detection of its occurrence and immediate intervention to treat the condition, because any delay may lead to difficulty or failure of treatment. Therefore, the successful surgeon investigates for signs of leakage and speeds up diagnosis and treatment
The peak of leakage occurs on the first and fourth day after surgery and appears in the form of a rapid pulse and rapid respiratory movements with abdominal pain and a rise in the patient’s temperature.
There are several methods to confirm the diagnosis such as radiography with injection of contrast material ..
There are several treatment plans that depend on the time of the leak, its cause, time of discovery, and the general condition of the patient at the time of treatment. We often need a quick surgical intervention with laparoscopic or conventional surgery, depending on the experience of the surgeon, the available capabilities, and the patient’s condition. It ranges from discontinuation of oral feeding to administration of parenteral nutrition with good drainage of the extra-abdominal fistula. And we may need to put an endoscope stent to exclude the intake of fluids and secretions from the fistula area.. Parenteral nutrition can be replaced by placing a tube through the skin that delivers food directly to the small intestine during surgery to treat leakage.
These procedures continue for several weeks until the fistula heals
There is an increase in the success rate of treating complications due to the early detection of leakage and the start of treatment in the golden period before the deterioration of the general condition of the patient.
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