Aims
We aimed to assess the outcomes of patients treated endoscopically for post-gastric sleeve leaks in a single tertiary referral centre in Ireland, with a particular assessment of the use of VacStents. These patients had primary surgeries done various helath centres.
Methods
Retrospectively data was collected from EndoRaad (endoscopy reporting system) in the hospital was conducted to assess for all patient reports that contained ‘VacsSent’ or ‘Post-sleeve leak’ or similar variations for the years 2021-2025 and we collected the data from radiology system for same patients to assess the procedural burden until the leak was healed.
Results
11 patients had endoscopic treatment of post-bariatric leak, 9 of which were female. The median age was 48 (range 28-66). Surgeries were performed in Turkey (6), Ireland (3), Spain (1) and Poland (1).
Overall the median time from surgery to first stent was 17 days for patients for whom the date of operation is available.
7 patients (64%) have achieved healing with endoscopic therapy. A further 3 patients have had surgery, and the final patient is undergoing active surveillance to assess for healing. VacStent was used in 7 patients (64%) Three of these patients (43% of Vacstent cohort) achieved healing. The median number of OGDs was 6 (range 3-12). Median number of stents per patinet was 3 (range 1-7) and these included SEMS,OTSC and EndoVac.
Patients were also noted to have significant overall use of healthcare resources. 10 patients had radiological drainage of collections. Median number of CXR was 14(3-25) and median CT Abdomen & Pelvis was 4 (2-15). The median length of stay was 78 days (35-240).
Conclusions
VacStents were used in 64% of patients, with a 43% healing rate within that subgroup and 64% overall healing across the cohort. There were 3 surgical failures (27%) and 1 non‑surgical failure with persistent leak (9%). VacStents contributed meaningfully to closure in complex leaks but were rarely sufficient alone. Optimal outcomes depended on multimodal management integrating SEMS, OTSC, NJ feeding, and radiologic drainage. Despite the procedural burden, most patients achieved healing, underscoring the value of coordinated, stepwise care.