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