Endoscopic Ultrasound (EUS)–Guided Drainage of a Postsleeve Gastrectomy Subphrenic Collection Using a Lumen Apposition Stent

Sleeve gastrectomy is currently the most frequently performed bariatric surgery. Postoperative leaks represent the main cause of morbidity in up to 8% of patients with a mortality rate ranging between 0.1 and 5%. However, management of these leaks remains controversial. We report the case of a patient presenting with sepsis 2 weeks after surgery. A subphrenic collection and a leak were found on CT. Despite medical treatment, the patient did not show clinical improvement. Hence, we considered a transgastric endosonographic-guided drainage of the collection using an electrocautery-enhanced lumen-apposing metal stent (LAMS). The procedure underwent uneventfully, and the patient status improved rapidly. Two weeks later, the stent was withdrawn. A follow-up endoscopy 6 weeks later showed closure of the gastric wall defect.