Endoscopic management of erosion after banded bariatric procedures.
Surg Obes Relat Dis
; 13(11): 1875-1879, 2017 Nov.
Article
en En
| MEDLINE
| ID: mdl-28870760
ABSTRACT
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.Palabras clave
Texto completo:
1
Colección:
01-internacional
Base de datos:
MEDLINE
Asunto principal:
Complicaciones Posoperatorias
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Obesidad Mórbida
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Gastroplastia
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Endoscopía Gastrointestinal
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Remoción de Dispositivos
Tipo de estudio:
Observational_studies
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Prognostic_studies
Límite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Revista:
Surg Obes Relat Dis
Asunto de la revista:
METABOLISMO
Año:
2017
Tipo del documento:
Article