Brac Baptiste, Rebibo Lionel, Lemouel Jean-Philippe, Regimbeau Jean-Marc
Department of Digestive Surgery, Amiens University Hospital, Avenue René Laennec, 80054, Amiens cedex 01, France.
Department of Gastroenterology, Amiens University Hospital, Avenue René Laennec, 80054, Amiens cedex 01, France.
Obes Surg. 2016 Dec;26(12):3084-3085. doi: 10.1007/s11695-016-2388-5.
Gastric band slippage with formation of a gastric pouch is a frequent complication after gastric banding. There is no consensus on the treatment of this condition, which differs within and between centers. Here, we describe our treatment of a large gastric pouch after gastric band slippage. Despite removal of the band, the pouch caused oral feeding intolerance.
The video shows our treatment of large gastric pouch following gastric banding and surgical revision. A 45-year-old woman with history of gastric banding was referred to our center for persistent oral feeding intolerance following gastric band removal.
We found that a large gastric pouch was responsible for extrinsic compression and thus required revisional surgery after optimization of the patient's nutritional status. Video endoscopy revealed a large gastric pouch, which was responsible for oral feeding intolerance. Intra-operative exploration then revealed major adhesions, which had probably caused the pouch to form. During surgery that was somewhat analogous to sleeve gastrectomy, we removed the adhesions and resected the gastric pouch. The operating time was 70 min. An uneventful postoperative course enabled rapid discharge (on postoperative day 2).
The formation of a large gastric pouch is a rare complication of chronic gastric band slippage. Following nutritional optimization, surgery is required.
胃束带滑脱并形成胃袋是胃束带术后常见的并发症。对于这种情况的治疗尚无共识，各中心内部及之间的治疗方法存在差异。在此，我们描述了对胃束带滑脱后形成的大胃袋的治疗。尽管移除了束带，但胃袋仍导致经口进食不耐受。
该视频展示了我们对胃束带术后大胃袋及手术翻修的治疗。一名有胃束带手术史的45岁女性因胃束带移除后持续存在经口进食不耐受被转诊至我们中心。
我们发现一个大胃袋导致了外部压迫，因此在优化患者营养状况后需要进行翻修手术。视频内镜检查发现一个大胃袋，这是经口进食不耐受的原因。术中探查发现严重粘连，可能是导致胃袋形成的原因。在进行类似于袖状胃切除术的手术过程中，我们松解了粘连并切除了胃袋。手术时间为70分钟。术后恢复顺利，患者术后第2天即可快速出院。
大胃袋的形成是慢性胃束带滑脱的罕见并发症。在优化营养状况后，需要进行手术治疗。
