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胃旁路术后残胃急性扩张:影像引导手术方法。

Acute Gastric Dilation of the Post-Roux-en-Y Gastric Bypass Remnant Stomach: Image-Guided Surgery Approach.

机构信息

Department of Percutaneous Surgery, DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.

Department of General Surgery, Sanatorio de la Mujer, Rosario, Argentina.

出版信息

J Laparoendosc Adv Surg Tech A. 2021 Feb;31(2):166-170. doi: 10.1089/lap.2020.0729. Epub 2020 Sep 22.

Abstract

Bariatric surgery is an effective treatment for obesity and its associated morbidities. They are safe surgeries, their general complication rate is 0%-10%. However, acute gastric dilation is an unusual complication. It requires rapid diagnosis and treatment to avoid major complications. Image-guided surgery represents a group of minimally invasive procedures. Acute gastric dilation is a complication that can benefit from the application of this type of procedure. We present a report of patients with acute gastric dilation of the remnant as a complication after bariatric surgery, its resolution through image-guided surgery, and updating. A retrospective review of patients who presented postoperative complications after bariatric surgery was carried out. The time period was 10 years. All patients were operated on in a single center by the same surgical team. A total of 3507 bariatric procedures were analyzed (sleeve gastrectomy, 1929-55.1% ± 0.49%; Roux-en-Y gastric bypass [RYGB], 1403-40% ± 0.48%; other techniques, 175-4.9% ± 0.21%). The RYGB branch reported a total of 11 (0.78% ± 0.08%) complications, of which 2 (0.14% ± 0.03%) were reported as acute gastric dilation of the remnant. Acute gastric dilation of the post-RYGB remnant is a rare complication, but it can be serious. It is necessary to have a high suspicion to obtain an early diagnosis and treatment. Percutaneous gastrostomy is an image-guided procedure that can solve the problem temporarily or permanently.

摘要

减重手术是肥胖及其相关合并症的有效治疗方法。这些手术是安全的,其总体并发症发生率为 0%-10%。然而,急性胃扩张是一种不常见的并发症。它需要快速诊断和治疗,以避免严重的并发症。影像引导手术代表了一组微创程序。急性胃扩张是一种可以受益于这种类型手术应用的并发症。我们报告了一例减重手术后残余胃急性扩张的患者,通过影像引导手术解决了该并发症,并进行了更新。对接受减重手术后出现术后并发症的患者进行了回顾性分析。时间跨度为 10 年。所有患者均由同一手术团队在单一中心进行手术。共分析了 3507 例减重手术(袖状胃切除术 1929 例,占 55.1%±0.49%;Roux-en-Y 胃旁路术 1403 例,占 40%±0.48%;其他技术 175 例,占 4.9%±0.21%)。Roux-en-Y 分支报告了总共 11 例(0.78%±0.08%)并发症,其中 2 例(0.14%±0.03%)被报告为残余胃急性扩张。Roux-en-Y 胃旁路术后残余胃急性扩张是一种罕见的并发症,但可能很严重。需要高度怀疑以获得早期诊断和治疗。经皮胃造口术是一种影像引导的程序,可以暂时或永久解决问题。

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