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Aili A, Li X, Abudureyimu K. Intra-jejunal migration with intestinal obstruction and perforation after gastric banding: A case report. Heliyon 2023; 9:e20756. [PMID: 37860574 PMCID: PMC10582381 DOI: 10.1016/j.heliyon.2023.e20756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 09/24/2023] [Accepted: 10/05/2023] [Indexed: 10/21/2023] Open
Abstract
Laparoscopic adjustable gastric banding (LAGB) is an approved procedure in bariatric surgery. However, serious complications due to band erosion have been reported. There have been few reports of intestinal obstruction and perforation caused by gastric banding invading the gastric wall and migrating to the jejunum. Case introduction: A 56-year-old man was admitted to our hospital with right lower abdominal pain ten years after LAGB surgery. An intraoperative gastric band showed erosion of the gastric wall and movement down to the jejunum, resulting in intestinal obstruction and jejunal perforation. Conclusion: Patients should undergo regular outpatient gastroscopic follow-up after gastric band surgery to prevent serious complications.
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Affiliation(s)
- Aikebaier Aili
- Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830011, China
- Institute of General Surgery and Minimally Invasive Surgery, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830011, China
- Clinical Research Center for Gastroesophageal Reflux Disease, Weight Loss and Metabolic Surgery, Xinjiang Uyghur Autonomous Region, Urumqi 830011, China
| | - Xin Li
- Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830011, China
- Graduate School of Xinjiang Medical University, Urumqi 830054, China
| | - Kelimu Abudureyimu
- Department of Minimally Invasive Surgery, Hernia and Abdominal Wall Surgery, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830011, China
- Institute of General Surgery and Minimally Invasive Surgery, People's Hospital of Xinjiang Uyghur Autonomous Region, Urumqi 830011, China
- Clinical Research Center for Gastroesophageal Reflux Disease, Weight Loss and Metabolic Surgery, Xinjiang Uyghur Autonomous Region, Urumqi 830011, China
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Zhao W, Gao W, Li D, Jin L, Wu X, Liu H, Wang L, Zhao Y, Liu X, Chen P, Dong G. Management of esophagogastric fistula caused by adjustable gastric band erosion: A case report and literature review. Obes Res Clin Pract 2023; 17:428-431. [PMID: 37739856 DOI: 10.1016/j.orcp.2023.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 08/29/2023] [Accepted: 09/08/2023] [Indexed: 09/24/2023]
Abstract
Laparoscopic adjustable gastric banding (LAGB) is commonly used in the treatment of morbid obesity. However, with clinical application and long-term follow-up, the shortcomings of this procedure were also exposed, bringing about surgery-related complications include dysphagia, intragastric band migration, slippage, and gastric band erosion. Lower esophageal and gastric fistula is a rare but dangerous complication after LAGB. We describe a case of esophagogastric fistula occurring twelve years after a laparoscopic band procedure and its successful management in a multidisciplinary and staged manner, followed by a short review of the literature.
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Affiliation(s)
- Wen Zhao
- School of Medicine, Nankai University, Tianjin 300071, China; Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Wenxing Gao
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - Dingchang Li
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - Lujia Jin
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - XianSheng Wu
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Hao Liu
- School of Medicine, Nankai University, Tianjin 300071, China; Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Lei Wang
- Medical School of Chinese PLA, Beijing, China; Department & Institute of Urology, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China
| | - Yingjie Zhao
- Department & Institute of General Surgery, the Eighth Medical Center of Chinese PLA General Hospital, Beijing 100091, China
| | - Xianqiang Liu
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China
| | - Peng Chen
- Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China; Medical School of Chinese PLA, Beijing, China.
| | - Guanglong Dong
- School of Medicine, Nankai University, Tianjin 300071, China; Department & Institute of General Surgery, The First Medical Center of Chinese PLA General Hospital, Beijing 100853, China.
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Alam F, Ng S, Farooq D, Haque A, Payne R. Late gastric band erosion mimicking diverticulitis and sepsis. SURGICAL PRACTICE 2021. [DOI: 10.1111/1744-1633.12512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Fahreyar Alam
- Department of General Surgery Great Western Hospital Swindon UK
| | - Sherwin Ng
- Department of General Surgery Great Western Hospital Swindon UK
| | - Dilawar Farooq
- Department of General Surgery Great Western Hospital Swindon UK
| | - Ali Haque
- Department of General Surgery Great Western Hospital Swindon UK
| | - Richard Payne
- Department of General Surgery Great Western Hospital Swindon UK
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The importance of patient selection in bariatric surgery: One not fit for all. Case report of a preventable double severe complication after Laparoscopic gastric banding positioning. Int J Surg Case Rep 2020; 77S:S135-S138. [PMID: 33041257 PMCID: PMC7876932 DOI: 10.1016/j.ijscr.2020.09.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2020] [Revised: 09/01/2020] [Accepted: 09/01/2020] [Indexed: 01/28/2023] Open
Abstract
LAGB presents many severe complications. Wedge resection could allow to preserve a tailored gastric pouch limiting postoperative nutritional defects. Strict postoperative follow-up reduce the risk of severe complications.
Introduction Laparoscopic adjustable gastric banding (LAGB) is a minimal invasive, effective and reversible procedure, even if it is burdened by life threatening complications. Presentation of the case A 39 years-old female patient was admitted to our emergency department for abdominal pain and ileus and underwent an explorative laparoscopy. The LAGB was wrapped around the proximal portion of the stomach determining the erosion and ischemia of the great curvature region. It was removed and a large gastric resection of the great curvature was performed. Subsequently, a gastric leak with pleural abscess occurred with the beginning of the oral diet. It was successfully treated with fasting, intravenous antibiotics and a thoracic tube. Discussion LAGB is a restrictive procedure that compartmentalizes the upper stomach by placing a tight adjustable band around it. However severe and multiple complications can also occur. Slippage is one of the most frequent and dangerous complication. Partial gastric resection (comparable to sleeve gastrectomy) or total/subtotal gastrectomy on the limit of the scarring tissue is use requested in the latter case, with a high risk of postoperative leak. A strict postoperative follow-up is mandatory in order to early recognize any severe complications. Conclusion Strict follow-up in this special subset of patients, the bariatric ones, is mandatory in order to early identify and correct any postoperative complications, avoiding severe sequelae.
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Robinson TJ, Soriano C, Larsen M, Mallipeddi MK, Hunter JA, Chang L. Endoscopic removal of eroded laparoscopic adjustable gastric bands: a preferred approach. Surg Obes Relat Dis 2020; 16:1030-1034. [PMID: 32540149 DOI: 10.1016/j.soard.2020.04.034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/09/2020] [Accepted: 04/23/2020] [Indexed: 01/02/2023]
Abstract
BACKGROUND Complications related to laparoscopic adjustable gastric banding (LAGB) have led to an increased number of removals. An uncommon but potentially devastating complication is gastric band erosion into the gastric lumen, which can be managed by open surgical, laparoscopic, and endoscopic approaches. OBJECTIVE A wide array of management techniques has been reported for removal of LAGB that have eroded into the stomach. We describe the preferred method for successful endoscopic band removal at our institution. SETTING Community tertiary-care referral hospital accredited by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. METHODS A single-center, retrospective review of a prospectively maintained database was used to identify patients who underwent LAGB removal from 2009 to 2019. We identified the subset of patients with band erosion. We analyzed patient characteristics, presenting symptoms, diagnostic modalities, and method of band extraction. RESULTS A total of 132 patients underwent LAGB removal, among whom 22 (16.7%) patients were diagnosed with erosion. Seven (32%) patients underwent laparoscopic removal, 14 (64%) patients underwent endoscopic removal, and 1 patient (4%) underwent combined laparoscopic and endoscopic approach. These latter patients had variable amounts of erosion and buckle visibility, but all underwent endoscopic retrieval. We found that using an endoscopic retrograde cholangiopancreatography guidewire with an endoscopic retrograde cholangiopancreatography mechanical lithotriptor for band transection and snare for retrieval have been effective. CONCLUSIONS A standardized, multidisciplinary, and minimally invasive endoscopic approach for LAGB erosion has been found to be successful without the need for further surgical intervention and may be offered to patients upon discovery of erosion.
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Affiliation(s)
- Todd J Robinson
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Celine Soriano
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Michael Larsen
- Department of Gastroenterology, Virginia Mason Medical Center, Seattle, Washington
| | - Mohan K Mallipeddi
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Jeffrey A Hunter
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington
| | - Lily Chang
- Department of General, Thoracic, and Vascular Surgery, Virginia Mason Medical Center, Seattle, Washington.
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Lu V, Kanhere H. A case report of septic shock and splenic abscess formation secondary to gastric band erosion: A rare complication of laparoscopic adjustable gastric banding. Int J Surg Case Rep 2020; 69:55-57. [PMID: 32276217 PMCID: PMC7139125 DOI: 10.1016/j.ijscr.2020.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 03/12/2020] [Indexed: 12/11/2022] Open
Abstract
INTRODUCTION With the rising burden of obesity, bariatric surgery is becoming more common as a treatment option. Laparoscopic adjustable gastric banding (LAGB) is considered safe and effective and is a popular procedure in Australia. However there are recognised complications to be aware of such as band erosion which can lead to infection and abscess formation. PRESENTATION OF CASE A 59-year-old caucasian female presented with fevers, rigors and feeling generally unwell. She was previously fit and well with her only past medical history being LAGB 14 years prior. Clinically the patient was in septic shock and required intensive care admission for inotropic support. On investigations the CRP was 227 and abdominal computed tomography (CT) revealed a splenic abscess. Follow up upper gastrointestinal endoscopy diagnosed an eroded gastric band in the stomach. The patient proceeded to laparoscopy, a gastrotomy was performed and the band was removed. The splenic abscess was concurrently drained and the patient treated with an extended course of intravenous and oral antibiotics. DISCUSSION Band erosion is a rare but serious complications of LAGB surgery along with band slippage, pouch dilatation and abscess formation. Patients are often asymptomatic making early diagnosis difficult. Upper gastrointestinal endoscopy is used to locate the band and recommended treatment is band removal via laparoscopy or laparotomy. CONCLUSION Band erosion should be suspected in patients with a history of LAGB presenting with nonspecific symptoms such as abdominal pain or fevers. This case also highlights the importance of appropriate patient follow up post operatively and counselling of operative risks and long-term complications.
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Affiliation(s)
- Victoria Lu
- Upper Gastro-intestinal Surgical Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia.
| | - Harsh Kanhere
- Upper Gastro-intestinal Surgical Unit, The Queen Elizabeth Hospital, Adelaide, South Australia, Australia
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Application of Laparoscopic Radical Resection for Type III and IV Hilar Cholangiocarcinoma Treatment. Gastroenterol Res Pract 2020; 2020:1506275. [PMID: 32184814 PMCID: PMC7060852 DOI: 10.1155/2020/1506275] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2019] [Accepted: 12/26/2019] [Indexed: 02/07/2023] Open
Abstract
Background This study is aimed at investigating the feasibility and safety of the laparoscopic radical resection for treating type III and IV hilar cholangiocarcinoma (III/IV Hilar C). Methods Six patients with III/IV Hilar C were enrolled in our hospital. All patients underwent total laparoscopic surgery, including basic surgery (laparoscopic gallbladder, hilar bile duct, and common bile duct resection and hepatoduodenal ligament lymph node dissection) combined with left hepatic and caudate lobe resection/portal resection. The tumor size, operation time, intraoperative blood loss, and postoperative complications were observed. The follow-up of the patients after discharge was recorded. Results Surgery was successfully completed in 6 patients. We found that the tumor size of 6 patients ranged from 1.5 to 3.6 cm, with 4 lymph nodes. The operation time was 540-660 minutes, and the blood loss was 300-500 ml. One patient developed bile leakage after surgery, healed within 2 weeks after drainage. The postoperative hospital stay was 16 (13-24) days. There were 4 cases of negative bile duct margin tumor, 1 case was positive, and 1 case was not reported. All 6 patients were discharged smoothly without perioperative death. Regular examinations were conducted every 3 months after discharge, and the median duration was 7 months. Only 1 patient had a marginal dysplasia, and 5 patients had no obvious signs of recurrence. Conclusions Application of laparoscopic radical resection for III/IV Hilar C is safe and feasible and has good short-term efficacy with adequate preoperative evaluation, appropriate case selection, and precise operative strategy.
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Nasser H, Ivanics T, Leonard-Murali S, Genaw J. A case report of an adjustable gastric band erosion and migration into the jejunum resulting in biliary obstruction. Int J Surg Case Rep 2019; 64:139-142. [PMID: 31655283 PMCID: PMC6818341 DOI: 10.1016/j.ijscr.2019.10.025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2019] [Revised: 10/01/2019] [Accepted: 10/08/2019] [Indexed: 12/03/2022] Open
Abstract
LAGB can rarely erode into the stomach and migrate into the small bowel. Migration of the LAGB can result in bowel and biliary obstruction. Band erosion should be managed by removal of the LAGB.
Introduction Laparoscopic adjustable gastric band is a bariatric operation which has lost popularity due to its high rate of reoperation and complications such as band erosion. Erosion may be partial or complete with intragastric migration of the band. Once in the stomach lumen, the band has the potential to migrate into the small bowel. Presentation of case A 43-year-old male with history of morbid obesity and laparoscopic adjustable gastric band placement presented with abdominal pain secondary to biliary obstruction. Endoscopic retrograde cholangiopancreatography revealed eroded gastric band tubing into the lumen of the stomach and duodenum with resultant distortion of the ampulla. Upon surgical exploration, the band was found to have migrated into the jejunum and was removed through an enterotomy. The patient did well and was discharged home on postoperative day 8. Discussion Once completely eroded into the gastric lumen, a gastric band can migrate into the small bowel with the distance traveled being limited by the length of the connecting tube. The stretched tubing can result in distortion of the ampulla leading to biliary obstruction. Band erosion should be managed with band removal which can be completed using endoscopic, laparoscopic, or open approach. Conclusion Band migration should be suspected in patients with a history of gastric band placement presenting with bowel or biliary obstruction. Its management depends on the location of the band as well as the expertise of the surgical team.
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Affiliation(s)
- Hassan Nasser
- Department of Surgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA.
| | - Tommy Ivanics
- Department of Surgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA
| | | | - Jeffrey Genaw
- Department of Surgery, Henry Ford Hospital, 2799 W Grand Blvd, Detroit, MI 48202, USA
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Technical Details and Result of a Minimally Invasive Management of Gastric Band Erosions: a Series of 47 Patients. Obes Surg 2019; 29:3754-3761. [PMID: 31520303 DOI: 10.1007/s11695-019-04170-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Laparoscopic adjustable gastric banding (LAGB) is proven to be a safe and effective treatment option for obesity in the long term. However, in recent decades, LAGB prevalence progressively decreased worldwide principally due to the incidence and the management of the complications. Understanding the optimal management of the complications becomes therefore of primary importance. The aim of this study is to describe a personal technical, laparoscopic solution of band erosion and to analyze outcomes in 47 patients. METHODS From October 1995 to January 2019, 3697 LAGB were performed at our institution. Since November 2011, an original laparoscopic gastric banding removal technique was introduced. All the bands placed in these patients were Lap-Band AP System (Allergan, Irvin, CA). The data of the patients who underwent gastric band removal because of band erosion were retrieved from a prospectively collected institutional database, and used for the present retrospective evaluation. RESULT Ninety-four patients (2.5% of the entire casuistic) with eroded band were diagnosed and treated at our institution. Forty-seven patients were treated with the laparoscopic gastric banding removal technique introduced in November 2011. All the operations have been performed laparoscopically with no conversion or intraoperative complications. There were neither major complications nor peri-operative (30 days) mortality. CONCLUSION Proper preoperative management and a standardized minimally invasive technique could help to cope with erosion, the most frightening complication of LAGB. Understanding the optimal management of complications and safe reoperation techniques can contribute to a rational use of the LAGB, reversing the current declining tendency.
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10
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The bigger they are: Video tips and techniques for managing acute care surgery emergencies in the postbariatric surgery patient. J Trauma Acute Care Surg 2019; 87:247-250. [PMID: 31259874 DOI: 10.1097/ta.0000000000002272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Novel Endoscopic Management of Eroding Laparoscopic Adjustable Gastric Band: A Case Series. Case Rep Gastrointest Med 2019; 2018:2747852. [PMID: 30693117 PMCID: PMC6332995 DOI: 10.1155/2018/2747852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2018] [Accepted: 12/11/2018] [Indexed: 12/24/2022] Open
Abstract
Complications of laparoscopic adjustable gastric bands include migration and slippage of the band, dilation of the proximal gastric pouch, troublesome gastroesophageal reflux symptoms, and erosion of the stomach. The latter occurs in 0.6-12.7% of cases and necessitates removal of the band. Several open and laparoscopic surgical techniques have been described for band extraction, while fully endoscopic techniques have emerged and proven safe. Three cases of eroding gastric bands treated in a single center with fully endoscopic removal of the band are analyzed in this study. Novel use of the duodenoscope and endoscopic retrograde cholangiopancreatography instruments and accessories is described, in order to perform endoscopic division of the plastic band and retraction through the mouth. All three cases were successfully treated utilizing this novel technique. Gastric wall erosion from the band has nonspecific symptoms and various predisposing factors. Removal of the foreign material is required. Endoscopic procedures are effective in 77-92% of cases, avoiding general anaesthesia with low surgical morbidity. As a result patients are discharged early resolving quicker to a normal diet.
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Cardiogastric Fistula as a Rare Complication After Gastric Banding and Hiatal Hernia Surgery. Obes Surg 2019; 29:1023-1027. [PMID: 30617915 DOI: 10.1007/s11695-018-03682-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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13
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Widmer JD, Schade S, Muller MK. A 13-year journey of a gastric band - ultimate destination terminal jejunum: a case report. J Med Case Rep 2018; 12:297. [PMID: 30326953 PMCID: PMC6192350 DOI: 10.1186/s13256-018-1850-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Accepted: 09/17/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Laparoscopic adjustable gastric banding has been the gold standard for surgical management of obesity over the last decades in USA and Europe. However, significant complications have been documented due to foreign body placement, including band erosions. Our treatment approach for erosions is rather observant with regular follow-up until the band has sufficiently perforated the gastric wall which facilitates endoscopic removal. Consequences of a not followed-up band erosion may present even after a long time following initial diagnosis with more severe complications. CASE PRESENTATION A 51-year-old Caucasian woman presented to our out-patients' clinic with a 2-week history of worsening abdominal pain in her left upper quadrant, exacerbated by abdominal flexion and extension maneuvers. Here we describe a case involving gastric penetration and subsequent downward migration of a band into distal jejunum causing small bowel obstruction, which occurred more than 10 years following initial diagnosis of erosion. The perforation was missed due to cessation of endoscopic follow-up. CONCLUSION Prospective and long-term follow-up is mandatory in those with partial band erosion to avoid further complications.
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Affiliation(s)
- Jeannette D Widmer
- Department of Surgery, Kantonsspital Frauenfeld, 8500, Frauenfeld, Switzerland.
| | - Stephanie Schade
- Department of Surgery, Kantonsspital Frauenfeld, 8500, Frauenfeld, Switzerland
| | - Markus K Muller
- Department of Surgery, Kantonsspital Frauenfeld, 8500, Frauenfeld, Switzerland
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Giet L, Baker J, Favretti F, Segato G, Super P, Singhal R, Ashton D. Medium and long-term results of gastric banding: outcomes from a large private clinic in UK. BMC OBESITY 2018; 5:12. [PMID: 29686879 PMCID: PMC5897937 DOI: 10.1186/s40608-018-0189-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/07/2018] [Accepted: 03/29/2018] [Indexed: 01/06/2023]
Abstract
Background Laparoscopic adjustable gastric band (LAGB) has been an established bariatric procedure for the last three decades and was, for many years, the first-choice procedure for the treatment of chronic obesity. However, more recently, the popularity of the LAGB has been in sharp decline and has been replaced by other procedures such as the Roux-En-Y gastric bypass and sleeve gastrectomy. A key driver in this decline has been the high revision and early explanation rates reported in some studies. Methods This was a retrospective study of 2246 patients who underwent LAGB at a large private clinic in the UK between June 2004 and October 2014. Results 2246 patients were included in the study; 1945 (84.6%) were women. All patients were followed up for 2 years following their procedure and subsequent follow up was at the discretion of patients. Mean follow up duration was 43.7 +/− 29.3 months. Operative mortality was zero and there were no in-hospital returns to theatre. Mean preoperative weight and body mass index (BMI) were 111.2 ± 22.1 kg and 39.9 ± 6.7 kg/m2 respectively. Mean excess % BMI loss at 1-, 2-, 5- and 8-years of follow-up was 43.1 ± 25.4, 47.9 ± 31.9, 52.4 ± 41.7 and 57.1% ± 28.6 respectively. There was no significant difference in mean excess % BMI loss between those < 50 or ≥ 50 years old (p value = 0.23) or between patients with an initial BMI of < or ≥ 50 kg/m2 (p value = 0.65). Complications over nine years occurred in 130 (5.8%) patients and included: 39 (1.7%) slippage or pouch dilatation, 2 (0.04%) erosions and 76 (3.4%) problems related to the access port or LAGB tubing. The overall re-operation rate for LAGB complications was 4.2% over 9 years with a LAGB explantation rate of 1.5%. 39 LAGBs were converted to a sleeve or gastric bypass procedure, 11 of these due to complications. Conclusion This is the first study to report on LAGB outcomes from a private clinic in the UK. LAGB is a safe procedure, which delivers significant and durable weight loss with acceptable complications rates and low re-operation rate.
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Affiliation(s)
- Leeying Giet
- 1Heart of England NHS Foundation Trust, Birmingham, UK
| | - Julia Baker
- Healthier Weight Centres, 11 Highfield Road, B15 3DU, Birmingham, UK
| | - Franco Favretti
- Healthier Weight Centres, 11 Highfield Road, B15 3DU, Birmingham, UK
| | - Gianni Segato
- Healthier Weight Centres, 11 Highfield Road, B15 3DU, Birmingham, UK
| | - Paul Super
- 1Heart of England NHS Foundation Trust, Birmingham, UK.,Healthier Weight Centres, 11 Highfield Road, B15 3DU, Birmingham, UK
| | - Rishi Singhal
- 1Heart of England NHS Foundation Trust, Birmingham, UK.,Healthier Weight Centres, 11 Highfield Road, B15 3DU, Birmingham, UK
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Aneese AM, Yang SK, Cappell MS. Case Report of Successful Medical Management of Progressive Gastric Band Penetration-to-Perforation After Band Insertion at Bariatric Surgery: Documentation by 12 Serial EGDs During 50 months of Observation. Dig Dis Sci 2018; 63:257-263. [PMID: 29134298 DOI: 10.1007/s10620-017-4783-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 09/25/2017] [Indexed: 12/09/2022]
Affiliation(s)
- Andrew M Aneese
- Division of Gastroenterology and Hepatology, Department of Medicine, William Beaumont Hospital, MOB 602, 3535 West Thirteen Mile Road, Royal Oak, MI, 48073, USA
| | - Sung K Yang
- Division of Gastroenterology and Hepatology, Department of Medicine, William Beaumont Hospital, MOB 602, 3535 West Thirteen Mile Road, Royal Oak, MI, 48073, USA
| | - Mitchell S Cappell
- Division of Gastroenterology and Hepatology, Department of Medicine, William Beaumont Hospital, MOB 602, 3535 West Thirteen Mile Road, Royal Oak, MI, 48073, USA. .,Oakland University William Beaumont School of Medicine, Royal Oak, MI, USA.
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