Staple Line Leaks Following Primary Laparoscopic Sleeve Gastrectomy. A Nationwide Multicenter Analysis
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ID: 315806
2026
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Abstract
Abstract Background Staple line leakage (SLL) is a major complication after primary laparoscopic sleeve gastrectomy (PLSG) and is associated with increased morbidity and mortality. This study aimed to identify patient-related and technical risk factors for SLL. Aims The aim of this study was to identify factors associated with the occurrence of staple line leakage following primary laparoscopic sleeve gastrectomy (PLSG). In addition, the association between selected technical aspects of the procedure and the incidence of staple line leakage (SLL) was evaluated. Methods All adult patients undergoing PLSG between 2005 and 2020 were retrospectively analyzed using data from the German Bariatric Surgery Registry (GBSR). Demographics factors, comorbidities, anthropometrics, perioperative variables, intraoperative events and staple line techniques were evaluated for their association with SLL. Associations with SLL were quantified using odds ratios (OR) with 95% confidence intervals and p-values. Results Among 27,542 patients, 309 (1.1%) developed SLL. Of these, 116 patients (37.5%) were male and 193 (62.5%) were female. Male sex was associated with a higher risk of SLL (OR 1.031). Smoking (p = 0.004), arterial hypertension (OR 1.263), and obstructive sleep apnea (OR 1.146) were significant risk factors. Patients with SLL had a markedly higher rate of conversion from laparoscopy to laparotomy (OR 2.801). Both BMI and body weight were significantly associated with leak occurrence (p = 0.047 and p = 0.014, respectively). Intraoperative complications substantially increased the risk of SLL (OR 3.613). The absence of staple line reinforcement was associated with higher leak rates compared with reinforced staple lines or interrupted suturing techniques (OR 1.326 and 1.256). Conclusion SLL following LSG is a multifactorial complication influenced by patient-related characteristics and technical factors. While complete prevention may not always be feasible, adherence to standardized surgical techniques and careful preoperative risk assessment may significantly reduce the incidence of SLL.
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| Authors | O Thaher, M Elshafei, S Pouwels, P Burri, M Hukauf, R S Croner, C Stroh |
| Journal | the british journal of surgery |
| Year | 2026 |
| DOI |
10.1093/bjs/znag055.004
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| URL | |
| Keywords | Keywords not found |
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