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腹腔镜袖状胃切除术后并发胃支气管瘘

Gastrobronchial Fistula Following a Laparoscopic Sleeve Gastrectomy.

作者信息

Saliba Christian, Nicolas Gregory, Diab Samer, Joudi Ihab, Tayar Claude

机构信息

Department of Surgery, Clemenceau Medical Center, Beirut, Lebanon.

Lebanese American University Medical Center - Rizk Hospital (LAUMCRH), Beirut, Lebanon.

出版信息

Am J Case Rep. 2019 Jan 8;20:31-35. doi: 10.12659/AJCR.910596.

Abstract

BACKGROUND Bariatric operations have been gaining more ground over the past decade. The most commonly used bariatric operation is the laparoscopic sleeve gastrectomy. A complication of laparoscopic sleeve gastrectomy is gastric leak; which can rarely cause a primary subphrenic abscess and a secondary diaphragm rupture that will lead eventually to a gastrobronchial fistula. CASE REPORT We present the case of a 32-year-old patient who started having symptoms suggestive of gastrobronchial fistula at 2 months following laparoscopic sleeve gastrectomy. CONCLUSIONS The treatment of a gastrobronchial fistula is controversial as this complication is rarely covered in published studies. Our expert opinion for this patient case was to opt for a surgical approach seeing that the complexity and severity of the fistula had a low chance of subsiding after only conservative measures.

摘要

背景

在过去十年中,减肥手术越来越普遍。最常用的减肥手术是腹腔镜袖状胃切除术。腹腔镜袖状胃切除术的一种并发症是胃漏;胃漏极少会导致原发性膈下脓肿和继发性膈肌破裂,最终导致胃支气管瘘。病例报告:我们报告一例32岁患者,在腹腔镜袖状胃切除术后2个月开始出现提示胃支气管瘘的症状。结论:胃支气管瘘的治疗存在争议,因为该并发症在已发表的研究中很少涉及。对于该病例,我们的专家意见是选择手术治疗,因为仅采取保守措施后,瘘管的复杂性和严重性使其消退的可能性较低。

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