Percutaneous Transesophageal Gastro-tubing: A New Treatment Strategy for Gastric Leakage after Sleeve Gastrectomy

The number of laparoscopic sleeve gastrectomy (LSG) performed worldwide is increasing continuously. Serious complications are relatively rare, but staple line leakage after LSG remains one of the most dreaded acute complications. Endoscopic treatments play a major role in treating sleeve leakage after initial surgical or percutaneous perigastric abscess control. Despite the high success rate of endoscopic treatments, some patients who fail treatment can develop refractory chronic leakage or fistula; therefore, they require revision operation such as Roux-en-Y gastric bypass or even total gastrectomy. We herein comment on percutaneous transesophageal gastro-tubing (PTEG) as a non-endoscopic, non-surgical alternative treatment option in patients for whom it may be desirable to avoid complex reoperation for sleeve leakage.