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腹腔镜可调节胃束带术期间发生食管穿孔:转为开腹袖状胃切除术并放置内镜支架

Esophageal perforation during laparoscopic adjustable gastric band: conversion to open sleeve gastrectomy and endoscopic stent placement.

作者信息

Papadimitriou G, Vardas K, Kyriakopoulos G, Alfaras K, Alfaras P

出版信息

G Chir. 2015 Mar-Apr;36(2):70-3.

Abstract

Laparoscopic adjustable gastric band (LAGB) is one of the most popular bariatric surgical procedures both in Europe and United States, because it is considered to be a safe and effective way of treating morbid obesity. This minimally invasive frequently employed bariatric procedure has many reported complications, but only a few cases of esophageal perforation have been reported. We present a case of iatrogenic esophageal perforation in an 18-year-old patient occurring during attempt to place an adjustable gastric band laparoscopically, which was diagnosed intraoperatively. Conversion to open sleeve gastrectomy with primary suturing of the perforation and drainage were performed. On the early postoperative period leak from the intra-abdominal part of the esophagus was diagnosed and treated with endoscopic placement of a self-expandable metal stent. After 2-years of follow-up the patient continues to have no sequelae from the perforation or symptoms of dysphagia, while Excess Weight Loss is 74.

摘要

腹腔镜可调节胃束带术(LAGB)在欧洲和美国都是最受欢迎的减肥手术之一,因为它被认为是治疗病态肥胖的一种安全有效的方法。这种微创且经常使用的减肥手术有许多报道的并发症,但仅有少数食管穿孔的病例被报道。我们报告一例18岁患者在腹腔镜置入可调节胃束带的过程中发生医源性食管穿孔,术中得以诊断。遂转为开腹行袖状胃切除术,同时对穿孔进行一期缝合及引流。术后早期诊断出食管腹腔段漏出,并通过内镜置入自膨式金属支架进行治疗。经过2年的随访,患者穿孔未遗留后遗症,也没有吞咽困难症状,体重减轻了74。

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