Staple line leakage after laparoscopic sleeve gastrectomy in Japan: a nationwide survey

Laparoscopic sleeve gastrectomy (LSG) is the most frequently performed procedure; however, the treatment of staple line leakage is very complicated. Therefore, this study assessed the incidence and treatment outcomes of staple line leakage in Japan.

The first survey of patients with leakage after LSG until September 30, 2022, was sent to 83 Japanese institutions. The second survey was sent to institutions that reported patients with leakage after LSG. The timing of conversion to curative surgery was statistically analyzed.

Thirteen institutions (15.7%) reported staple line leakage in 21 patients after LSG. The incidence was 0.41%, and the leakage sites were close to the angle of His in > 90% of the patients. Initial management was successful in 30.0% of patients, while the remaining patients required additional management. After intervention, 25.0% of patients underwent conversion surgery as curative management, and the optimal timing was 83.5 days after leakage detection.

The rate of staple line leakage after LSG was low, but difficult to treat. Conversion to curative surgery may be determined after approximately 12 weeks.