GASTRIC LEAK POSSIBLE

Thanks to its impressive success rate, the gastric sleeve has grown in popularity to become one of the most sought-after and trusted weight-loss surgeries globally. About 80-90% of gastric sleeve surgeries end up successful.

But what happens to the 10%?

With hundreds of thousands of people going through the procedure annually and many surgeons getting qualifications to perform the procedure, it is uncommon to hear of complications.

However, when they do occur, they need to be addressed quickly.

One common complication is a gastric sleeve leak. What is it, how do you know you have one, and how should you address it?

What Is A Gastrointestinal Leak?

Also called a gastrointestinal leak, a gastric sleeve leak results in digestive juices and partly digested food leaking into the abdominal cavity. It can also occur with other forms of bariatric surgery such as gastric bypass and duodenal switch.

Gastric sleeve surgery is performed by removing a portion of your stomach, usually 80% of it, to form a small sleeve or tube. This procedure limits the amount of food someone can take and how quickly the person feels hungry.

During the procedure, the surgeon has to cut the unwanted portion of the stomach and sew together the remaining portion. This connection forms a potential source of a gastric sleeve leak.

A gastrointestinal leak is one of the most dreaded complications because of the significant morbidity and mortality risk. Moreover, they are hard to diagnose. Some tests and radiological studies may give deceitful results, and the symptoms vary greatly.

Types of Gastrointestinal Leaks

A gastrointestinal leak is classified according to its emergence. It can be:

1. Early leak – this appears between days one and three after the surgery.
2. Intermediate leak – this appears between days four and seven after the surgery.
3. Late leak – this develops during or after day 8 of surgery.

These leaks can also be classified based on location and reason for development. Some leaks develop due to technical difficulties during the surgery. Others are caused by patient-related factors such as recent or current smoking history, poor nutrition, renal failure, or liver cirrhosis.

Depending on its severity, a leak may also be clinical or subclinical.

Understanding the types allows the surgeon to properly diagnose the leakage based on its unique set of symptoms and take the appropriate action for management.

How Common Are Gastric Sleeve Leaks?

The incidence of gastric sleeve leaks is very low. However, given its severity, surgeons are advised to be very vigilant.

Studies show different results when it comes to quantifying the incidences. The 2011 International Sleeve Gastrectomy Expert Panel Consensus Statement put the leak rate at 1.06%.

Other studies range between 1% and 5% for patients receiving the procedure for the first time. That figure shoots to 10% for patients undergoing a revision procedure. The spike in the latter is attributed to the increased dissection the surgeon has to make when re-operating.

Who Is at Risk?

The more obese you are, the more likely you will suffer from a gastrointestinal leak. However, other factors come into play, such as your gender, health problems, and surgical history.

Generally, males are at more risk. Having other health problems can also increase the likelihood of developing a leak. Also, if you’ve had abdominal surgery in the past, you’re very likely to suffer from a gastric sleeve leak.

Common Symptoms

Symptoms of a gastric sleeve leak manifest differently in each person. The most common ones are:

• Increased heart rate (tachycardia), higher than 120 beats per minute
• Chills
• Fever higher than 98.6⁰F or 37⁰C
• Worsening abdominal pain
• Tachypnea or respiratory distress
• Shoulder pain and/or chest pain
• Fluid leaking from an incision site
• Dizziness
• Nausea and vomiting
• A general feeling of anxiety and illness
• Less urine
• Low blood pressure

These symptoms might look similar to those of other health conditions in most cases. So, make sure you contact a healthcare provider for a thorough diagnosis.

How to Diagnose A Leak

Your healthcare provider will ask about your symptoms. Then, they’ll provide a physical exam. They may also require imaging tests such as upper GI (gastrointestinal) series or a CT scan. Either test will require you to drink a contrast dye. This special liquid makes the images show up easier.

If the image tests don’t show any signs of a leak, but you still have the symptoms, the healthcare provider may advise you to get emergency surgery to find the leak.

How A Gastric Sleeve Leak is Treated

A gastric sleeve leak must be treated right away. The healthcare provider will most likely:

• Give you antibiotics through an IV (intravenous line)
• Drain any infection resulting from the leak
• Repair the leak or make a new anastomosis or cut through a second surgery
• Stop giving all food by mouth. You will most likely be fed through a tube directly into your intestine until the leak has healed.

You should talk to your healthcare provider about the benefits, risks, and possible side effects of all treatments.

Get the Help of a Qualified Surgeon

The likelihood of developing a gastric sleeve leak is also strongly tied to the surgeon’s qualifications. Get in touch with a professional team for the best results and the least chances of complications.