Cintolo Jessica A, Levine Marc S, Huang Stephanie, Dumon Kristoffel
Department of Surgery, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
J Laparoendosc Adv Surg Tech A. 2012 Jul-Aug;22(6):591-4. doi: 10.1089/lap.2012.0132. Epub 2012 Jun 12.
Intraluminal erosion of a laparoscopic gastric band into the stomach has been reported as a complication of laparoscopic adjustable gastric banding. To our knowledge, however, intraluminal erosion of the band tubing into the duodenum has not been described.
We report a 46-year-old man in whom a laparoscopic adjustable gastric band tubing eroded into the duodenal lumen, causing recurrent port-site infections. This complication was diagnosed on upper endoscopy and also, in retrospect, on an upper gastrointestinal barium study and computed tomography.
The patient underwent surgical removal of the band and tubing, with a primary duodenal repair, and made a complete recovery without complications.
Erosion of laparoscopic band tubing into the duodenum should be included in the differential diagnosis for recurrent port-site infections after laparoscopic adjustable gastric banding. Radiographic or endoscopic visualization of the intraluminal portion of the tubing may be required for confirmation. Definitive treatment of this complication entails surgical removal of the tubing from the duodenum.
腹腔镜胃束带向胃内的管腔内侵蚀已被报道为腹腔镜可调节胃束带术的一种并发症。然而，据我们所知，束带管道向十二指肠的管腔内侵蚀尚未见报道。
我们报告一名46岁男性，其腹腔镜可调节胃束带管道侵蚀至十二指肠腔，导致反复的穿刺部位感染。该并发症通过上消化道内镜检查确诊，回顾性分析时也通过上消化道钡餐检查和计算机断层扫描确诊。
患者接受了束带和管道的手术切除，并进行了十二指肠一期修复，完全康复且无并发症。
腹腔镜束带管道向十二指肠的侵蚀应纳入腹腔镜可调节胃束带术后反复穿刺部位感染的鉴别诊断中。可能需要通过影像学或内镜检查来观察管道的管腔内部分以确诊。该并发症的确定性治疗需要手术将管道从十二指肠取出。
