Aims Bariatric surgery is increasingly being performed, and among its complications, leaks
are the most serious and life-threatening. Our aim is to investigate the outcomes
of endoscopic interventions on patients with post-bariatric surgery leakage and to
explore the factors influencing success, failure, and complications.
Methods This was a cross-sectional study involving patients referred to our clinic for endoscopic
treatment of leaks after bariatric surgery between April 2014 and October 2023. The
analysis evaluated bariatric procedure type, leak site, treatment timing, endoscopic
findings, intervention details, presence of distal sleeve stricture, complications,
and mortality.
Results Sixty-one patients (36 females, 59.02%) with a median age of 38 (33 – 49) years were
included. Fifty-five patients (90.16%) were successfully treated with endoscopic treatment
methods. Among 55 patients, 12 patients (19.67%) were treated with bariatric stent
only, 10 patients (16.39%) were treated with internal drainage only, and 7 patients
(11.48%) were treated with an over-the-scope clip only. In other patients (42.62%),
different endoscopic treatment methods and percutaneous drainage were used in combination.
Endoscopy-related complications occurred in 12 (19.67%) patients, with the most common
being stent migration (6.56%). Endoscopic intervention had failed and required re-surgery
in six (9.84%) patients. One (1.64%) patient died due to sepsis following re-surgery.
Unsuccessful cases had significantly larger self-limited cavity sizes (p=0.009). The
endoscopic intervention count was significantly higher among those with endoscopy-related
complications (p=0.030). The number of endoscopic interventions was correlated with
self-limited cavity presence (r=0.482, p<0.001) and use of internal drainage (r=0.477,
p<0.001).
Conclusions Endoscopic management of leaks that develop after bariatric surgery can achieve high
success rates with the combined use of different techniques. Various factors, such
as the presence of a self-limited cavity and the size of the cavity, are influential
factors in the development of complications or treatment failure.
