Waidner Uta, Henne-Bruns Doris, Wolf Anna Maria
Department of General, Visceral and Transplantation Surgery, University Hospital Ulm, Ulm, Germany.
Obes Surg. 2007 Jan;17(1):108-11. doi: 10.1007/s11695-007-9015-4.
A complication observed with revisional surgery involving a fistula between the former pouch after gastric banding and the fundus is described. A 59-year-old man with BMI 41 kg/m(2) presented for Roux-en-Y gastric bypass (RYGBP). He had previously undergone an open gastric banding operation, with the band removed for obstruction 1 year later. He presented to our hospital with a third incisional hernia which was so large that he suffered from abdominal angina following meals. A RYGBP and a hernia repair with mesh were performed. The postoperative contrast x-ray study disclosed a fistula between the pouch and fundus. A procedure to close the fistula became necessary. The reason for the fistula may have been an erosion at the former connection between the pouch and the fundus after gastric banding, although a preoperative gastroscopy had not revealed this fistula.
本文描述了在涉及胃束带术后原胃袋与胃底之间瘘管的翻修手术中观察到的一种并发症。一名体重指数（BMI）为41kg/m²的59岁男性因 Roux-en-Y 胃旁路手术（RYGBP）前来就诊。他此前接受过开放式胃束带手术，1年后因梗阻取出了束带。他因第三次切口疝前来我院，该疝非常大，以至于他饭后出现腹部绞痛。遂进行了RYGBP和用补片修补疝的手术。术后造影X线检查发现胃袋与胃底之间存在瘘管。因此有必要进行闭合瘘管的手术。瘘管形成的原因可能是胃束带术后胃袋与胃底先前连接处的侵蚀，尽管术前胃镜检查未发现此瘘管。
