Management of anastomotic leaks-early <7 days and late >7 days

Anastomotic leaks are among the most dreaded and challenging complications encountered by acute care surgeons, with attendant high morbidity and mortality. A thorough understanding of risk factors leading to anastomotic leaks can help the acute care surgeon anticipate complications and provide treatment that can reduce the incidence or limit the effects of these complications. Re-operative surgery should never be undertaken lightly, and therefore, accurate diagnosis and localization of anastomotic leaks are critical prior to undertaking definitive management. A number of operative and non-operative treatment options exist in the management of anastomotic leaks that can provide satisfactory results. The presentation and treatment of early (<7 days) versus late (>7 days) anastomotic leaks can be markedly different. In this chapter, we discuss the risk factors, diagnosis, and treatment of gastric, intestinal, colorectal, and pancreatic anastomotic leaks in both the early and late postoperative periods.