Management of total esophageal obstruction after stenting for sleeve gastrectomy leak

The rising prevalence of morbid obesity has increased the demand for bariatric surgery and obesity surgery has become a sustainable treatment for morbid obesity worldwide. Sleeve gastrectomy is the most frequently performed bariatric surgical procedure for its technical simplicity and low complication rates. However, staple-line leaks at the angle of His occur in up to 3% of patients. Endoscopic placement of self-expandable metal stents is a common and effective therapeutic modality. Esophageal stricture or obstruction following stent placement is an extremely rare complication of an otherwise successful stenting procedure. We report the case of a patient with complete esophageal obstruction who required a combined endoscopic and open surgical approach for restoration of esophageal lumen and transit.