Successful Over-the-Scope Clip closure of persistent leak after Roux-en-Y gastric bypass surgery

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Introduction Roux-en-Y gastric bypass surgery is widely accepted in the treatment of morbid obesity. Anastomotic leakage is one of the most commonly reported and feared complications. The complete healing of the leak is challenging and in some cases may need to utilize endoscopic interventions, such as Over-the-Scope Clip. Case report A 57-year-old male with a medical history of diabetes mellitus and morbid obesity underwent a Roux-en-Y gastric bypass surgery. The patient manifested a staple-line anastomotic leakage. After one week of conservative management, a 1.5cm persistent leakage was confirmed both radiologically (Figure) and endoscopically (Figure), so an endoscopic closure with over the scope clip using the suction method was performed (Figure). Leakage of gastric liquids stopped after OTS-clip closure. No recurrence of the leakage was observed during the 12-month follow-up [ 1 ] [ 2 ] [ 3 ] [ 4 ]. Conclusions In conclusion, although various methods at treating leakages have been utilized, over-the-scope clip has recently gained growing interest with encouraging results in the management of early leaks after bariatric surgery. Publication History Article published online: 27 March 2025 © 2025. European Society of Gastrointestinal Endoscopy. All rights reserved. Georg Thieme Verlag KG Oswald-Hesse-Straße 50, 70469 Stuttgart, Germany

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