Management and outcomes of gastric leak after sleeve gastrectomy: results from the 2010–2020 national registry

作者：Mengyi Li, Na Zeng, Yang Liu, Xitai Sun, Wah Yang, Yanjun Liu, Zhongqi Mao, Qiyuan Yao, Xiangwen Zhao, Hui Liang, Wenhui Lou, Chiye Ma, Jinghai Song, Jianlin Wu, Wei Yang, Pin Zhang, Liyong Zhu, Peirong Tian, Peng Zhang, Zhongtao Zhang, for the Greater China Metabolic and Bariatric Surgery Database (GC-MBD) study group · 发表于：Chinese Medical Journal · 年份：2023 · DOI：10.1097/cm9.0000000000002499 · 被引用次数：19 · 研究领域：Bariatric Surgery and Outcomes、Gastric Cancer Management and Outcomes、Esophageal and GI Pathology

BACKGROUND: Management of gastric leak after sleeve gastrectomy (SG) is challenging due to its unpredictable outcomes. We aimed to summarize the characteristics of SG leaks and analyze interventions and corresponding outcomes in a real-world setting. METHODS: To retrospectively review of 15,721 SG procedures from 2010 to 2020 based on a national registry. A cumulative sum analysis was used to identify a fitting curve of gastric leak rate. The Kaplan-Meier method and log-rank tests were performed to calculate and compare the probabilities of relevant outcomes. The logistic regression analysis was conducted to determine the predictors of acute leaks. RESULTS: A total of 78 cases of SG leaks were collected with an incidence of 0.5% (78/15,721) from this registry (6 patients who had the primary SG in non-participating centers). After accumulating 260 cases in a bariatric surgery center, the leak rate decreased to a stably low value of under 1.17%. The significant differences presented in sex, waist circumference, and the proportion of hypoproteinemia and type 2 diabetes at baseline between patients with SG leak and the whole registry population ( P = 0.005, = 0.026, <0.001, and = 0.001, respectively). Moreover, 83.1% (59/71) of the leakage was near the esophagogastric junction region. Leakage healed in 64 (88.9%, 64/72) patients. The median healing time of acute and non-acute leaks was 5.93 months and 8.12 months, respectively. Acute leak (38/72, 52.8%) was the predominant type w...