Facchiano Enrico, Scaringi Stefano, Sabate Jean-Marc, Merrouche Mohamed, Jouet Pauline, Coffin Benoit, Msika Simon
Department of Surgery, Louis Mourier Hospital, Colombes, France.
Obes Surg. 2007 Jun;17(6):832-5. doi: 10.1007/s11695-007-9127-x.
Laparoscopic adjustable gastric banding (LAGB) has become an increasingly popular option to treat morbid obesity. Esophageal dysmotility secondary to LAGB has been described, but is usually reversible after removal of the band. Long-term esophageal dysmotility persisting after removal of the band is an unusual and not yet described complication. We report the case of a 58-year-old obese patient who developed severe dysphagia and vomiting associated with atypical esophageal dysmotility 22 months after gastric band placement. Radiological exploration revealed no acute band slippage but only a pseudoachalasia. Device deflation and then band removal were required in an attempt to treat her symptoms. Esophageal dysmotility persisted for several months after band removal and was still present after a Roux-en-Y gastric bypass performed as revisional operation. Possible mechanisms generating this complication and clinical implications are discussed.
腹腔镜可调节胃束带术（LAGB）已成为治疗病态肥胖越来越受欢迎的选择。继发于LAGB的食管动力障碍已有报道，但通常在移除束带后可逆转。束带移除后持续存在的长期食管动力障碍是一种不寻常且尚未被描述的并发症。我们报告一例58岁肥胖患者，在放置胃束带22个月后出现严重吞咽困难和呕吐，并伴有非典型食管动力障碍。影像学检查未发现急性束带滑脱，仅发现假性贲门失弛缓症。为缓解其症状，需要先对装置进行放气，然后移除束带。束带移除后食管动力障碍持续了数月，在作为修正手术进行的Roux-en-Y胃旁路术后仍存在。本文讨论了产生这种并发症的可能机制及其临床意义。
