Diagnosis
gastric leak, fistula, gastro-cutaneous fistula
FREE FLUID
After full history taking and complete physical examination, post-LSG gastric leak was clinically suspected and then confirmed by laboratory investigations (complete blood picture, liver and kidney functions, coagulation profile), radiological imaging (chest X-ray, computed tomography (CT) with oral and I.V contrast) and upper GI endoscopy to assess the site, size and cause of the leak. We adopted a protocol of initial radiological or laparoscopic drainage according to the amount of intraperitoneal free fluid detected by CT scan, then endoscopically inserting a stent. If the leak did not satisfactorily respond to the initial measures within 6 weeks (recommended period of 5–8 weeks by the stent’s manufacturer and asa routine in our hospital for complete healing and easy extraction of the stent), a persistent gastric leak or fistula was considered, and the patient was evaluated for eligibility to be included in this study. The included eligible patients underwent another upper GI endoscopy to reconfirm site and size of the fistula, and CT abdomen with oral and I.V contrast to determine whether the fistula had a track (gastro-cutaneous fistula) or not (gastric leak).