الفهرس 
Anatomy of stomachOnly 14 pages are availabe for public view
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Abstract
Obesity causes large health problems as the obese subjects show a higher risk of developing severe diseases such as type II diabetes, cancer, cardiovascular risk, hypertension and hyperlipidemia, moreover, there is 2.6 million obesity related deaths every year. Laparoscopic sleeve gastrectomy (LSG), also known as longitudinal or vertical gastrectomy, is considered as an effective surgical option for the management of morbid obesity. Aims to assess the feasibility of the recent methods in management of post sleeve gastrectomy leak including indication and proper application of each method. We believe that leaks are not a consequence of staple-line failure or dehiscence; rather, we believe that the presence of gastric-wall heat ischemia near the staple line, which may be caused by dissection of the greater curvature using electrocautery or the LigaSure device, may be a major cause of leak. The clinical presentation of postoperative gastric leak ranges from asymptomatic radiographic finding to peritonitis, septic shock, multisystem organ failure, and death. Combination of clinical signs of fever, tachycardia and tachypnea was found to be specific for detection of anastomotic leaks. Diabetes mellitus and sleep apnea were associated with a greater incidence of anastomotic leak. In contrast, treatment of a delayed gastric leak is more challenging surgically owing to the presence of an inflammatory reaction. In this setting, attempts to repair the leak are usually futile.