Dr Salina’s report on the use of self-expandable metal stents (SEMS) in the treatment
of gastric leaks is an important report in a number of ways. With the continued increase
in patients undergoing bariatric surgical procedures comes an increase in the small
but important number of patients having the known complications of leak and sepsis.
Although published series have shown that nonoperative management of gastric leaks
after RYGB is safe in certain circumstances, even with success the patients managed
in such a way often suffer significantly. Many surgeons have become less enamored
with such an approach, although operative intervention has significant risks and often
is unsuccessful in completely controlling the leak. New techniques aimed at treating
and minimizing the morbidity to those patients who leak are certainly necessary and
have an indirect impact on the field as a whole in terms of the now closely monitored
and widely published mortality rates.
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© 2007 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
