Conducta frente a filtraciones post gastrectomía vertical

Abstract

Background: Sleeve gastrectomy is one of the most commonly used bariatric surgical procedures. Aim: To analyze clinical and laboratory manifestations and management of leaks after sleeve gastrectomy. Material and Methods: Analysis of 20 patients with leaks out of 785 operated subjects (2.5%). Symptoms and laboratory changes were analyzed. Leak was classified according to the postoperative day of appearance, its location and its severity. Results: Fever, abdominal pain and tachycardia were the main clinical manifestations of the leak. Patients also had leukocytosis and an elevated C reactive protein. In 12 (60%) patients, the leak appeared within the first four postoperative days, in three, it appeared between the fifth and ninth postoperative day and in five, after the tenth postoperative day. In 90%, the leak was near the cardias. Eleven patients were reoperated and nine were managed conservatively. The leak closed 34 and 55 days after its appearance among patients managed conservatively or surgically, respectively. Conclusions: Leaks are a serious complication of sleeve gastrectomy and require a close surveillance of patients.