Abstract:

Gastric leakage is the most critical and severe complication after laparoscopic sleeve gastrectomy (LSG) combined with fundoplication. We aimed to report a case treated with endoscopic negative pressure therapy for gastric leakage after LSG combined with fundoplication. The patient was diagnosed with metabolic syndrome and gastroesophageal reflux disease (GERD) before surgery. The patient underwent LSG combined with fundoplication. The patient was readmitted to the hospital due to gastric leakage on postoperative day 10 and underwent fundoplication flap resection and leakage site resection. The patient was complicated with gastric leakage on postoperative day 5. Endoscopic negative pressure therapy and a nasojejunal feeding tube were inserted and given enteral and parenteral nutrition. Multiple abdominal punctures and drainage were performed during the whole treatment process. CT of the upper abdomen and gastric radiography identified a cure for the leakage 2 months after surgery. For obese patients with GERD, the safety of LSG combined with fundoplication needs to be further evaluated. For patients with postoperative gastric leakage, endoscopic negative pressure therapy is effective and safe, which is worthy of clinical reference.

Key words: Sleeve gastrectomy, Fundoplication, Gastric leakage, Gastroesophageal reflux disease, Endoscopic negative pressure therapy