Management of total esophageal obstruction after stenting for sleeve gastrectomy leak

Pamela Milito, Stefano Siboni, Daniele Bernardi, Emanuele Asti, Luigi Bonavina

Abstract

The rising prevalence of morbid obesity has increased the demand for bariatric surgery and obesity surgery has become a sustainable treatment for morbid obesity worldwide. Sleeve gastrectomy is the most frequently performed bariatric surgical procedure for its technical simplicity and low complication rates. However, staple-line leaks at the angle of His occur in up to 3% of patients. Endoscopic placement of self-expandable metal stents is a common and effective therapeutic modality. Esophageal stricture or obstruction following stent placement is an extremely rare complication of an otherwise successful stenting procedure. We report the case of a patient with complete esophageal obstruction who required a combined endoscopic and open surgical approach for restoration of esophageal lumen and transit.