Table 2.
Leak-related data of the included studies in the meta-analysis.
| First author, year, reference | Leak rate | Diagnosis | Time after OAGB | Leak management | Reoperation (due to leak) | Death after leak |
|---|---|---|---|---|---|---|
| Scavone et al., 20209 | 5 of 953 (0.5%) | CT scan Oral contrast series |
First week | N/A | N/A | 0% |
| Bashah et al., 202010 | 1 of 49 (2%) | N/A | ‘shortly’ | Surgery: conversion to RYGB | 1 (100%) | 0% |
| Lessing et al., 202011 | 2 of 57 (3.51%) | N/A | N/A | N/A | N/A | 0% |
| Neuberg et al., 202012 | 1 of 163 (0.61%) | N/A | ‘early’ | N/A | N/A | 0% |
| Liagre et al., 201913 | 46 of 2780 (1.7%) | Oral CT scan Endoscopic findings Intraoperative |
10 days (1–42) |
Medical (N=9): fasting, total parenteral nutrition, and antimicrobial therapy Interventional/endoscopy (N=23): percutaneous drainage and/or endoscopy Surgery: laparoscopy: washout and drainage (+T-tube placement in 5 cases) (N=13); conversion to RYGB (N=1) |
14 (30%) | 0% |
| Sohrabi Maralani et al., 202114 | 1 of 805 (0.1%) | N/A | N/A | N/A | 1 (100%) | 100% (1) |
| Debs et al., 202015 | 1 of 77 (1.3%) | N/A | N/A | Surgery (N=1): Kehr tube and drainage | 1 (100%) | 0% |
| Younis et al., 202016 | N/A | CT scan | Less than 4 weeks | Interventional/endoscopy: all had fully covered stents (N=9) Surgery: laparotomy RYGB conversion (N=2) Laparotomy after 2 weeks of treatment due to stent migration and ileum perforation |
2 (22%) | 11% (1) |
| Musella et al., 201717 | 13 of 2251 (0.6%) | N/A | N/A | Surgery depending on the leak site
Anastomotic leak (N=5): -laparoscopic revision/Braun anastomosis (N=2) -laparoscopic repair (N=1) -laparoscopic reversal surgery (N=1) -conservative treatment/laparotomy (N=1) Gastric pouch leak (N=7): -laparoscopic repair (N=5) -conservative treatment (N=1) -revision/laparotomy (N=1) Gastric remnant leak: -laparoscopic repair (N=1) |
11 of 13 (84.6%) | 1 (7.7%) |
| Lessing et al., 201718 | 7 of 407 (1.7%) | N/A | 6.5 days (2–14) | Medical: fasting, total parenteral nutrition, and antimicrobial therapy (N=3) Surgery: laparoscopic drainage (N=3), laparoscopic drainage after failed percutaneous drainage (N=1) |
3 of 407 (0.73%) | 0% |
| Nevo et al., 202119 | 1 of 21 (4.7%) | N/A | N/A | Interventional (N=1): percutaneous drainage | 0% | 0% |
| Musella et al., 201920 | 1 of 196 (0.5%) | N/A | N/A | N/A | N/A | N/A |
| Nagliati et al., 201922 | 1 of 8 (12.5%) | Intraoperative | 1 day | Surgery (N=1): no details | 1 (12.5%) | N/A |
| Poublon et al., 202023 | 1 of 185 (0.5%) | N/A | N/A | N/A | N/A | 0% |
| Meydan et al., 201724 | 1 of 154 (0.65%) | Clinical presentation: septic shock | 4 days | Surgery (N=1): laparoscopic conversion to RYGB | 1 (100%) | N/A |
| Bolckmans et al., 201925 | 5 of 526 (0.95%) | N/A | N/A | Surgery (N=5): laparoscopic conversion to RYGB | 5 (100%) | N/A |
| Alkhalifah et al., 201826 | 20 of 1731 (1.15%) | N/A | N/A | N/A | N/A | N/A |
| Chansaenroj et al., 201727 | 2 of 26 (7.7%) | N/A | N/A | Surgery (N=2): laparoscopic exploration, repair and drainage | 2 (100%) | 0% |
| Apers et al., 201828 | 4 of 287 (1.4%) | N/A | N/A | Medical (N=2): feeding tube Surgery (N=2): laparoscopy (no details) |
2 (50%) | N/A |
| Almalki et al., 201829 | 5 of 81 (6.2%) | N/A | N/A | N/A | N/A | N/A |
| Genser et al., 201630 | 35 of 2321 (1.5%) | Systematic oral contrast series (N=4) Oral CT scan (N=4) Intraoperative (N=27) |
9 days (97%) (0–28) |
Surgery (N=35): all had washout and drainage: -laparoscopy (N=33) -laparotomy (N=2) Interventional/endoscopy (N=2): in addition to surgery in patients with large staple lines breakdown needing endoscopic stenting |
35 (100%) | 0% |
| de la Cruz et al., 202031 | 1 of 42 (2.4%) | N/A | N/A | Surgery (N=1): laparoscopy (no details) | 1 (100%) | N/A |
| Parmar and Mahawar, 201832 | 123 of 12 807 (0.96%) | N/A | N/A | N/A | N/A | N/A |
| Soong et al., 201933 | 5 of 940 (0.5%) | N/A | N/A | N/A | N/A | N/A |
| Parmar et al., 202036 | 1 of 376 (0.3%) | <30 days | N/A | Surgery: conversion to RYGB | 1 (100%) | N/A |
| Khalaj et al., 202037 | 3 of 548 (0.5%) | Oral CT scan | <30 days | Interventional (N=2): drainage and intravenous antibiotics Surgery (N=1): urgent peritoneal lavage and antimicrobial therapy |
1 (33%) | 1 (0.18%) |
| Salama and Sabry, 201638 | 1 of 39 (2.6%) | N/A | 2 days | Surgery (N=1): direct suture of the injured bowel | 1 (100%) | 0 |
| Taha et al., 201739 | 2 of 1520 (0.1%) | N/A | 2 days | Surgery (N=2): -conversion to RYGB (N=1) -repair of the defect (N=1) |
2 (100%) | 0 |
| AlSabah et al., 201840 | 2 of 31 (6.45%) | CT scan | N/A | Interventional/endoscopy (N=2): -stent (N=1) -percutaneous drainage (N=1) |
0% | 0% |
| Pujol Rafols et al., 201841 | 5 of 191 (2.6%) | N/A | N/A | N/A | N/A | 0% |
| Beaupel et al., 20174 | 10 of 1430: study conducted among 17 patients with leakage after OAGB – but 10 had undergone an initial OAGB in the center, which leads to a leak rate of 0.7% (10/1430) |
Oral CT scan (88% ) Intraoperative |
4 days (1–28) | Surgery (N=14): -conversion to RYGB (N=4): leak of the GT or the GJA: conversion was performed lavage, drainage, and treatment of the perforation (T-tube intubation N=2, suture N=1, anastomosis resection and refection N=1) |
14 (100%) | 0% |
| Carbajo et al., 200542 | 4 of 209 (1.9%) | Oral contrast series | 1 day | Medical: conservative management (no details) | 0% | 0% |
| Noun et al., 201243 | 5 of 1000 (0.5%) | Oral contrast series | 1 week (2 leaks) 2 weeks (3 leaks) |
Medical/interventional: -cutaneous fistula that healed with conservative management more than 2 weeks after surgery (N=3) -percutaneous drainage (N=3) Surgery: suturing of the GT and drainage (N=1) -conversion to RYGB after failed percutaneous drainage (N=1) |
2 (40%) | 0% |
| Chevallier et al., 201545 | 6 of 1000 (0.6%) | N/A | ‘early’ | Surgery (N=6) (no details) | 6 (100%) | 0% |
| Ghosh et al., 201746 | 1 of 74 (1.35%) | N/A | ‘early’ | Interventional (N=1): percutaneous drainage | 0% | 0% |
| Plamper et al., 201748 | 1 of 169 (0.6%) | N/A | ‘early’ | N/A | N/A | 0% |
| Bruzzi et al., 201550 | 1 of 126 (0.79%) | Intraoperative | N/A | Surgery (laparotomy), no details | 1 (100%) | 0% |
| Johnson et al., 20078 | N/A | N/A | N/A | Surgery (N=3): -conversion to RYGB (N=2) |
3 (100%) | 0% |
| Kular et al., 201455 | 2 of 1054 (0.2%) | N/A | 2 | Surgery (laparotomy), repair (no details) | 2 (100%) | 0% |
| Musella et al., 201456 | 10 of 974 (1%) | N/A | 1–12 days | Surgery (N=6) (no detail) | 6 (60%) | 1 (0.001%) |
| Wang et al., 200557 | 9 of 423 (2.1%) | N/A | N/A | Medical (N=6): total parenteral nutrition for minor leakage (N=6) Surgery (N=3): reoperation for drainage |
3 (33%) | 1 (0.23%) |
| Docimo et al., 202258 | 3 of 279 (1.1%) | N/A | N/A | Surgery (N=1) (no details) | 1 (33%) | N/A |
| Rayman et al., 202159 | 2 of 144 (1.4%) | N/A | N/A | N/A | N/A | N/A |
| Rutledge and Walsh, 200560 | 26 of 2410 (1.1%) | Intraoperative | N/A | Surgery: (no details) Laparoscopic re-exploration and repair | N/A | No |
| Almuhanna et al., 202161 | 19 of 2223 (0.85%) | N/A | N/A | N/A | N/A | 2 (0.09%) |
| Goel et al., 202162 | 7 of 3187 (0.2%) | CT scan Oral contrast series Ultrasounds |
N/A | Medical/interventional: pigtail, drainage Surgery: laparoscopy (no details) |
N/A | No |
| Garcia-Caballero et al., 200563 | 1 case report | Oral contrast series | N/A | Medical/interventional: total parenteral nutrition, endoscopic fibrin glue | N/A | No |
CT scan, computed tomography scan; oral CT scan, orally ingested computed tomography scan; GJ anastomosis, gastrojejunal anastomosis; GT, gastric tube; reoperation, number of patients with a leak who needed a reoperation and percentage; OAGB, one-anastomosis gastric bypass; RYGB, Roux-en-Y gastric bypass.