ENDOSCOPIC INTERNAL DRAINAGE (EID) OF SUTURE-LINE DEHISCENCE POST-LAPAROSCOPIC GASTRIC SLEEVE (LGS): SIMPLER THAN ENDOSCOPIC VACUUM THERAPY (EVT) AND MORE EFFECTIVE THAN INTRALUMINAL COVERED SEMS

Introduction EVT improves outcomes over SEMS for endotherapy of postoperative leaks but requires repeated procedures. We show simplified EID using transmural double-pig-tail stents.

Description Acute post-LSG leak shown on abdominal CT. Endotherapy included EID and 35-mm balloon dilatation of antral stricture. Guidewire was passed at EGD into perigastric collection through suture-line defect. Following wire-guided balloon dilation: abscessoscopy, saline irrigation and placement of two 7F-pigtail stents. 12-weeks later, pig-tail-stents were removed and resolution was confirmed at EGD.

Conclusions An acute infradiaphragmatic post-LSG leak was effectively managed by EID with two double pigt-tail stents requiring just two EGD with minimal patient discomfort.