Management of gastric fold herniation after laparoscopic adjustable gastric banded plication: a single-center experience
| Autor: | Anshuman Dev, Po-Chih Chang, Chih-Kun Huang, Ming-Che Hsin, Chi-Ming Tai, Abhishek Katakwar |
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| Rok vydání: | 2016 |
| Předmět: |
Adult
Reoperation medicine.medical_specialty Gastroplasty Trocar site hernia Stomach Diseases Gastric stenosis 030209 endocrinology & metabolism Gastric fold Single Center Young Adult 03 medical and health sciences Postoperative Complications 0302 clinical medicine Weight Loss medicine Humans Prospective Studies Major complication Abscess Retrospective Studies business.industry medicine.disease University hospital Curvatures of the stomach Hernia Abdominal Obesity Morbid Surgery Female Laparoscopy 030211 gastroenterology & hepatology business |
| Zdroj: | Surgery for Obesity and Related Diseases. 12:849-855 |
| ISSN: | 1550-7289 |
| DOI: | 10.1016/j.soard.2016.02.017 |
| Popis: | Background Laparoscopic adjustable gastric banded plication (LAGBP) is a novel bariatric procedure, and little is known about its potential complications. Objectives Herein, we report on complications of LAGBP and discuss the clinical features and diagnostic and therapeutic strategies in such situations, with emphasis on gastric fold herniation (GFH). Setting University Hospital. Methods Prospectively collected data of 223 patients who underwent LAGBP for morbid obesity between August 2009 and December 2014 were retrospectively analyzed. Follow-up at 1 year was 75%. Results Eight patients (3.5%) required readmission due to major complications, including 1 trocar site hernia, 1 band leak, 1 gastric stenosis, and 5 GFHs. GFHs occurred mostly in the first postoperative month (4/5, 80%) and at the fundus (5/5, 100%); 4 GFHs occurred in the initial 70 patients. Seven laparoscopic reoperations were required for managing GFH. The gastric band was removed in 3 patients (of 5; 60%). Two patients developed residual intra-abdominal abscess and were treated successfully by image-guided drainage. In March 2012, we reversed the order of our surgical techniques for the subsequent 153 patients and performed greater curvature plication first, followed by band placement. Only one GFH occurred after this change in surgical order (1/153 versus 4/70; P Conclusions High clinical suspicion assisted by radiological investigations and early surgical intervention is the key for managing GFH after LAGBP. Though GFH complications were rare, we significantly reduced its occurrence by altering the surgical order in LAGBP to plication followed by banding. |
| Databáze: | OpenAIRE |
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