A Novel Minimally Invasive Salvage Technique for One Anastomosis Gastric Bypass Leaks: A Preliminary Case Series

Anastomotic leak after one-anastomosis gastric bypass (OAGB) remains a serious postoperative complication with significant morbidity and mortality. Despite multiple available strategies, no standardized approach exists for managing gastrojejunostomy leaks. This study presents a simple, minimally invasive technique designed to control leakage and promote tract closure.

This single-centre case series included five consecutive patients who developed gastrojejunostomy leaks following OAGB between 2020 and 2025. All patients were managed using a novel minimally invasive technique involving placement of a Foley catheter through the leak site to achieve internal sealing, combined with controlled external drainage. Clinical data, postoperative course, and outcomes were recorded.

Five patients (mean age 44.4 years; mean BMI 55.4 kg/m²) were treated using this technique. All leaks were identified at the gastrojejunostomy, with onset ranging from 2 to 7 days postoperatively. Oral fluid intake was initiated on the second day following clinical improvement. Median postoperative hospital stay was 4 days. The Foley catheter was maintained for a mean duration of 23.8 days before removal. All patients were followed up, with a mean follow-up duration of 4 months.

This minimally invasive salvage technique appears feasible and safe for managing gastrojejunostomy leaks after OAGB. It offers a straightforward alternative that supports controlled external drainage and facilitates leak closure. Larger studies are needed to validate its reproducibility and broader applicability.