The Temporary Placement of Covered Self-Expandable Metal Stents to Seal Various Gastrointestinal Leaks after Surgery

• Published in: Gut and liver Vol. 7; no. 1; pp. 112 - 115
• Main Authors: Choi, Hye Jung, Lee, Bo-In, Kim, Jin-Jo, Kim, Ji Hoon, Song, Joo Yong, Ji, Jeong Seon, Kim, Byoung-Wook, Choi, Hwang, Choi, Kyu Yong
• Format: Journal Article
• Language: English
• Published: Korea (South) The Korean Society of Gastroenterology; the Korean Society of Gastrointestinal Endoscopy; the Korean Association for the Study of the Liver; the Korean Society of Neurogastroenterology and Motility; Korean Association for the Study of Intestinal Diseases; Korean College of Helicobacter and Upper Gastrointestinal Research; Korean Pancreatobiliary Association; Korean Society of Gastrointestinal Cancer 01.01.2013; Gastroenterology Council for Gut and Liver; 거트앤리버 소화기연관학회협의회
• Subjects: anastomotic leak; Case Report; drainage; stents; 내과학; Drainage; Anastomotic leak; Stents
• ISSN: 1976-2283; 2005-1212
• DOI: 10.5009/gnl.2013.7.1.112

Gastrointestinal leakage is one of the most serious post surgical complications and is a major source of mortality and morbidity. The insertion of a covered self-expandable metal stent could be a treatment option in selected cases. However, it is unclear how long the stent should be retained to achieve complete sealing, and membrane-covered stents have the problem of a high migration rate. We observed four cases of postsurgical leakage following the primary closure of a duodenal perforation, esophagojejunostomy, and esophagogastrostomy, each of which was successfully managed by the temporary placement of covered stents. In all cases, the optimal time of stent removal could be estimated by the markedly decreased amount of drainage, the lack of leakage observed on radiocontrast images, and the endoscopic findings. In this case series, all of the stents could be removed within 7 weeks. For those cases with a high risk of migration, stents with temporary fixations to earlobes and/or partially uncovered proximal flanges were used. These results suggest that the application of a covered stent could be a treatment option for various gastrointestinal leaks after surgery, particularly when the defect cannot be sealed by conservative care and the leakage has good external drainage.