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Successful Over-the-Scope Clip Closure of Persistent Leak after Roux-en-Y Gastric Bypass Surgery

Authors

Christos Sotiropoulos, Christos Konstantakis*, Georgios Theocharis, Christos Triantos, Konstantinos Thomopoulos

Department of Gastroenterology and Hepatology, University General Hospital of Patras, Greece.

Article Information

*Corresponding Author: Christos Konstantakis, Department of Gastroenterology and Hepatology, University General Hospital of Patras, Greece.

Received Date: January 01, 2025
Accepted Date: January 19, 2025
Published Date: January 27, 2025

Citation: Sotiropoulos C, Konstantakis C, Theocharis G, Triantos C, Thomopoulos K. (2025) “ Successful Over-the-Scope Clip Closure of Persistent Leak after Roux-en-Y Gastric Bypass Surgery.” International Surgery Case Reports, 7(1); DOI: 10.61148/2836-2845/ISCR/083
Copyright: © 2025. Christos Konstantakis. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Roux-en-Y gastric bypass surgery is widely accepted in the treatment of morbid obesity. Anastomotic leakage is one of the most commonly reported and feared complications. The complete healing of the leak is challenging and in some cases may need to utilize endoscopic interventions, such as Over-the-Scope Clip


Keywords: surgery

Introduction

Roux-en-Y gastric bypass surgery is widely accepted in the treatment of morbid obesity. Anastomotic leakage is one of the most commonly reported and feared complications. The complete healing of the leak is challenging and in some cases may need to utilize endoscopic interventions, such as Over-the-Scope Clip. 1-6

Case Report

A 57-year-old male with a medical history of diabetes mellitus and morbid obesity underwent a Roux-en-Y gastric bypass surgery. The patient manifested a staple-line anastomotic leakage. After one week of conservative management, a 1.5cm persistent leakage was confirmed both radiologically (Figure A) and endoscopically (Figure B), so an endoscopic closure with over the scope clip (OTSC) using the suction method was performed (Figure C). Leakage of gastric liquids stopped after OTSC closure. No recurrence of the leakage was observed during the 12-month follow-up.

Conclusions
In conclusion, although various methods at treating leakages have been utilized, over-the-scope clip has recently gained growing interest with encouraging results in the management of early leaks after bariatric surgery.

References

  1. Sousa M, Proença L, Rodrigues A. (2019) What's next after failure of OTSC® for the closure of gastrostomy fistula? Another OTSC®? Rev Esp Enferm Dig. 111(5):409.
  2. Bona D, Giovannelli A, Micheletto G, Campanelli G, Cavalli M, Bonitta G, Aiolfi A. (2020) Treatment of Persistent Leaks After Laparoscopic Sleeve Gastrectomy with the Simultaneous Over-the-Scope Clip (OTSC) and Mega Stent Strategy. Obes Surg. 30(9):3615-3619.
  3. Masaki S, Yamada K. (2021) Over-the-Scope Clip Closure of Persistent Gastrocutaneous Fistula After Percutaneous Endoscopic Gastrostomy Tube Removal: A Report of Two Cases. Cureus. 13(2):e13206.
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