Postoperative Bleeding and Leakage After Sleeve Gastrectomy: a Single-Center Experience

• Published in: Obesity surgery Vol. 26; no. 12; pp. 2944 - 2951
• Main Authors: Khoursheed, Mousa, Al-Bader, Ibtisam, Mouzannar, Ali, Ashraf, Aqeel, Bahzad, Yousef, Al-Haddad, Abdulla, Sayed, Ali, Fingerhut, Abe
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.12.2016; Springer Nature B.V
• Subjects: Adult; Anastomotic Leak - etiology; Female; Gastrectomy - adverse effects; Gastrectomy - methods; Gastrointestinal surgery; Hemorrhage; Humans; Laparoscopy - adverse effects; Laparoscopy - methods; Male; Medicine; Medicine & Public Health; Obesity; Obesity, Morbid - surgery; Original Contributions; Postoperative Hemorrhage - etiology; Postoperative period; Retrospective Studies; Surgery; Surgical outcomes; Single-incision surgery; Staple line reinforcement; Revisional surgery; Laparoscopic sleeve gastrectomy; Bleeding
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-016-2215-z

Background Sleeve gastrectomy is being performed increasingly, mainly due to its low morbidity and mortality, but complications do occur. The aim of this study was to evaluate bleeding and leakage rates of primary and revisional sleeve gastrectomy in a personal series of 664 consecutive patients. Methods Medical charts of all patients undergoing a primary or revisional sleeve gastrectomy between August 2008 and December 2014 were reviewed retrospectively. Subgroup analysis compared bleeding in patients after reduced port versus multiport technique and primary versus revisional sleeve gastrectomy. Results A total of 664 sleeve gastrectomies (489 women and 175 men) were performed. Mean age and body mass index were 36.03 ± 11.4 years and 42.9 ± 8.3 kg/m 2 , respectively. Mean operative time was 58.5 ± 20.0 min, with a 0.15 % conversion rate. Mean hospital stay was 2.1 ± 0.3 days. The overall 30-day complication rate was 7.5 %. Thirteen patients sustained postoperative bleeding (2 %), three of whom required reoperation (0.5 %). Staple line leakage and mortality were both nil in this series. No difference in postoperative complications was found between the subgroups. Conclusions In this single-surgeon, single-center experience, sleeve gastrectomy was a safe and effective bariatric procedure with a low complication rate. Staple line reinforcement by oversewing was associated with low bleeding complications and no leakage. The majority of patients with postoperative bleeding could be managed conservatively. In our experience, reduced port technique and revisional sleeve gastrectomy had similar complication rates compared to multiport and primary sleeve gastrectomy.