Tilak Shah presented a systematic review and meta analysis by Puli et al (PMID 22047699) on stenting leaks after bariatric surgery. Only seven papers met the criteria for inclusion, and those seven papers included a total of 67 patients. Due to the small sample size, confidence intervals for outcomes were quite wide. In addition, the studies used different types of stents, not all of which are available in the US. In our discussion, it became clear that placing these stents can be technically challenging, and may be associated with long-term complications such as stent migration, erosion of the stent, and fistula formation. We also acknowledged that a second operation in these patients carries a high risk of complications, and non-operative strategies for leaks is an important clinical need. We should expect further development in this area in the future, perhaps even using the sleeve devices being developed for endoscopic obesity treatment as a therapeutic option for leaks.
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