Endoscopic management of erosion after banded bariatric procedures
| Autor: | Matthew D. Spann, Wayne J. English, D. Brandon Williams, Chetan V. Aher |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Adult
Male Reoperation medicine.medical_specialty Gastroplasty Perforation (oil well) Endoscopy Gastrointestinal Postoperative Complications Port (medical) Pneumoperitoneum Operative report Humans Medicine Adjustable gastric band Device Removal Aged Retrospective Studies medicine.diagnostic_test business.industry Stomach Middle Aged medicine.disease Obesity Morbid Surgery Endoscopy medicine.anatomical_structure Seroma Female business Follow-Up Studies |
| Zdroj: | Surgery for Obesity and Related Diseases. 13:1875-1879 |
| ISSN: | 1550-7289 |
| DOI: | 10.1016/j.soard.2017.07.025 |
| Popis: | Background Prosthetic materials wrapped around a portion of the stomach have been used to provide gastric restriction in bariatric surgery for many years. Intraluminal erosion of adjustable and nonadjustable gastric bands typically occurs many years after placement and results in various symptoms. Endoscopic management of gastric band erosion has been described and allows for optimal patient outcomes. Objectives We will describe our methods and experience with endoscopic management of intraluminal gastric band erosions after bariatric procedures. Setting University hospital in the United States. Methods A retrospective review of our bariatric surgery database identified patients undergoing removal of gastric bands. A chart review was then undertaken to confirm erosion of prosthetic material into the gastrointestinal tract. Baseline characteristics, operative reports, and follow-up data were analyzed. Results Sixteen patients were identified with an eroded gastric band: 11 after banded gastric bypass, 3 after laparoscopic adjustable gastric band (LAGB), and 2 after vertical banded gastroplasty. All patients were successfully treated with endoscopic removal of the prosthetic materials using either endoscopic scissors or ligation of the banding material with off-label use of a mechanical lithotripter device. Complications included a postoperative gastrointestinal bleed requiring repeat endoscopy, 1 patient with asymptomatic pneumoperitoneum requiring observation, and 1 with seroma at the site of LAGB port removal. Conclusions Endoscopic management of intraluminal prosthetic erosion after gastric banded bariatric procedures can be safe and effective and should be considered when treating this complication. Erosion of the prosthetic materials inside the gastric lumen allows for potential endoscopic removal without free intraabdominal perforation. Endoscopic devices designed for dividing eroded LAGBs may help standardize and increase utilization of this approach. |
| Databáze: | OpenAIRE |
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