Evaluating the Impact of Intraoperative Leak Testing on Postoperative Complications in Sleeve Gastrectomy: A Retrospective Comparative Study

Introduction: During sleeve gastrectomy (SG), intraoperative leak testing (IOLT) is often done to detect problemswith the staple lines before the surgery is finished. Despite being widely used, there is still only limited and unevenevidence to support its ability to predict or stop surgical gastric leak (GL).Aim of work: The aim of this study was to find out if there was a link between IOLT and GL after surgery in peoplewho were having SG.Patients and methods: This retrospective comparative study was conducted on 400 patients, both sexes, aged18-65 years, body mass index (BMI ≥ 40 kg/m2) or with obesity-related comorbidities), and Scheduled for SG.Patients were divided into two equal groups: Group I underwent IOLT with SG, while Group II underwent SGwithout IOLT. Data were collected from surgical databases and medical records.Results: IOLT was negative in all patients in Group I. No significant differences were found in postoperative leakrates at 2 weeks, 30 days, or 3 months ((1.5% vs 0.5%, 0 vs 0 and 0 vs 0, respectively, P > 0.05). IOLT showed0% sensitivity and 98.5% specificity, with 0% positive predictive value and 100% negative predictive value. Nosignificant differences were observed in operative time, hospital stay, complications, or readmission.Conclusions: IOLT showed no added benefit in reducing postoperative complications after SG and failed to detectcases of leak, demonstrating zero sensitivity despite high specificity. These findings suggest that routine IOLToffers limited clinical value in SG and may be unnecessary in standard, uncomplicated cases.