Abstract:

Aim: This study aimed to review the technical and clinical results of cone-beam computed tomography (CBCT) fluoroscopy-guided drainage of anastomosis or staple line leakage, which is the most important complication after laparoscopic sleeve gastrectomy due to obesity. Methods: A retrospective analysis was performed of the demographic findings, clinical manifestations, leakage location, and medical data of 30 cases who underwent CBCT fluoroscopy-guided percutaneous drainage due to anastomosis or staple line leakage after sleeve gastrectomy due to obesity in the interventional unit of our hospital between February 2015 and September 2020. Results: A total of 48 drainage catheters were inserted in 30 patients (8 females and 22 males), aged 19–71 years (mean 51.24), under the guidance of CBCT fluoroscopy. Drainage was completed in a single session with one catheter in 13 (43.3%) patients. In 17 (56.7%) patients, the procedure was completed with two or more catheterizations in more than one session due to different leakage locations and subsequent occlusion or dislocation of the catheter. Inflammatory parameters and symptoms related to leakage regressed in 29 (94%) patients within 48–72 hours with clinical improvement. The success rate of percutaneous drainage was 100% without any complications. Conclusion: Anastomosis, or staple line leakage, is one of the most serious life-threatening complications that can be seen following laparoscopic sleeve gastrectomy. CBCT fluoroscopy-guided drainage is a safe, highly effective, and minimally invasive treatment option that has a low risk of complications. This technique can facilitate the treatment of postoperative collections with alternative treatment methods.

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