Management Options for Twisted Gastric Tube after Laparoscopic Sleeve Gastrectomy
| Autor: | Ibrahim Dawoud, Ayman El Nakeeb, Moataz Bashah, Maged Ali Gamal, Ashraf Abbas, Alaa Magdy, Mohamed Abd Ellatif, Davit Sargsyan, Asaad F Salama |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
medicine.medical_specialty
Sleeve gastrectomy Endocrinology Diabetes and Metabolism medicine.medical_treatment 030209 endocrinology & metabolism Gastropexy 03 medical and health sciences 0302 clinical medicine Postoperative Complications Gastrectomy medicine Humans Endoscopic stenting Digestive System Surgical Procedures Retrospective Studies Nutrition and Dietetics business.industry Gastric Obstruction Stomach Retrospective cohort study Surgery Obesity Morbid medicine.anatomical_structure Treatment Outcome Balloon dilation 030211 gastroenterology & hepatology Laparoscopy business |
| Zdroj: | Obesity surgery. 27(9) |
| ISSN: | 1708-0428 |
| Popis: | This study aims to determine the incidence, etiology, and management options for symptomatic gastric obstruction caused by axially twisted sleeve gastrectomy. In this retrospective study, we reviewed medical charts of all morbidly obese patients who underwent laparoscopic sleeve gastrectomy. Patients who developed gastric obstruction symptoms and were diagnosed with twisted sleeve gastrectomy were identified and included in this study. From October 2005 to December 2015, there are 3634 morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Eighty-six (2.3%) patients developed symptoms of gastric obstruction. Forty-five (1.23%) patients were included in this study. The mean time of presentation was 59.8 days after surgery. Upper GI contrast study was done routinely, and it was positive for axial twist in 37 (82%) patients. Abdominal CT with oral and IV contrast was done in eight (18%) when swallow study was equivocal. Endoscopic treatment was successful in 43 patients (95.5%). Sixteen patients were successfully managed by endoscopic stenting, and 29 patients had balloon dilation. The average numbers of dilation sessions were 1.7. Out of these 29 patients, 18 responded well to a single session of dilatation and did not require any further dilatation sessions. Two patients who failed to respond to three subsequent sessions of balloon dilation underwent laparoscopic adhesiolysis and gastropexy. Endoscopic stenting is an effective tool in management of axial rotation of sleeved stomach. Balloon dilation can also be effective in selected cases. Few cases might require laparoscopic adhesiolysis and gastropexy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink