Are there any recommendations as far as stent placement for leaks after sleeve gastrectomy?
Much is talked about stents for leaks after sleeve gastrectomy, but only because options are limited in this situation. Covered stents are subject to migration and patient intolerance. Many times, the stent does not control the leak completely. Despite these drawbacks, intraluminal stent placement along with good surgical drainage continues to be the best first-line option in the case of leak after sleeve gastrectomy. What is the recommended management of this patient at this time? This patient clearly needs another operation. Either the stent is not controlling the leak or the drain is not properly placed. Prior to surgery, this patient needs to be evaluated for distal obstruction either at the pylorus (vagotomy from band erosion or subsequent surgical injury?) or proximal due to narrowing or angulation of the sleeve. The site of the leak in relation to the esophagogastric junction and the presence or absence of a hiatal hernia is important in planning the next operation. If there is
