Gastric Leak After Laparoscopic Sleeve Gastrectomy: Management with Endoscopic Double Pigtail Drainage. A Systematic Review

Abstract Gastric leak remains the main complication after sleeve gastrectomy, but there are no standardized guidelines for its treatment. Good results have been reported using endoscopic double-pigtail stent. In order to estimate its effectiveness, we carried out this systematic review. Eleven eligible articles were identified by searching PubMed, Embase and Cochrane library. Three-hundred-eighty-fivepatients met inclusion criteria. The pooled proportion of successful leak closures by using double pigtail drainage was 83.41% The proportion of successful leak closures by using double pigtail drainage by experienced operators as first line treatment was 84.71% Our review suggested that double-pigtail stent could be a valid approach to manage the post-bariatric gastric leak, with low rate of complications and a good tolerance by patients. More high-quality studies with large samples sizes should be undertaken to better evaluate and compare the variety of techniques available.