Role of Endoscopic Suturing in Management of Persistent Post-Bariatric Surgery Leakage

Post-bariatric surgery leaks, although a rare event, still represent a challenging complication with absence of a definite algorithm for management. Recently, endoscopic suturing has emerged as a treatment option. Herein, we present a case of a persistent post-bariatric surgery leakage which resolved by endoscopic suturing a 48-year-old male patient presenting with weight gain after BPD-Larad procedure and fundoplication. Stapled reduction of the gastric pouch was done, followed by an early leakage. Leakage persisted despite laparoscopic suturing and twice endoscopic stenting. Endoscopic suturing with transient endoscopic stenting leads to complete healing of the site of leakage. Long-term follow-up was satisfactory. Endoscopic suturing presents a recent modality for management of post-bariatric staple line leakage even after revisional surgeries.