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腹腔镜袖状胃切除术后迟发性植物性胃石形成的罕见病例报告:延迟再次减重手术。

A rare case report of late-onset phytobezoar formation following laparoscopic sleeve gastrectomy: delayed redo bariatric surgery.

机构信息

Obesity Research Center, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

Department of Surgery, Faculty of Medicine, Tehran Obesity Treatment Center, Shahed University, Tehran, Iran.

出版信息

BMC Surg. 2021 May 22;21(1):254. doi: 10.1186/s12893-021-01254-8.

Abstract

BACKGROUND

Phytobezoar formation is a complication of bariatric surgery and mostly occurs after laparoscopic Roux-en-Y gastric bypass (LRYGB) operations. Here, we present an extremely rare case of late phytobezoar formation following laparoscopic sleeve gastrectomy (LSG).

CASE PRESENTATION

A 52-year-old woman with a body mass index (BMI) of 40.7 kg/m underwent LSG. Following persistent symptoms of nausea, vomiting, early satiety, and tremendous weight loss, endoscopy was performed, and gastric phytobezoar was detected at one-year post-operation. After endoscopic fragmentation, phytobezoar was removed by snare, and the patient later underwent redo bariatric surgery (conversion of LSG to LRYGB).

CONCLUSIONS

With an increase in the number of LSG procedures performed globally, and the late-onset nature of phytobezoar formation, more cases of this complication are expected to be detected in future. Long-term postoperative follow-up alongside applying surgical methods to avoid gastric stenosis are needed to reduce the chance of phytobezoar formation in patients undergoing LSG.

摘要

背景

植物性胃石形成是减重手术的一种并发症,主要发生在腹腔镜 Roux-en-Y 胃旁路术(LRYGB)之后。在此,我们报告一例腹腔镜袖状胃切除术(LSG)后极罕见的迟发性植物性胃石形成病例。

病例介绍

一名 52 岁女性,BMI 为 40.7kg/m²,接受了 LSG。术后持续出现恶心、呕吐、早饱和体重显著减轻等症状,行内镜检查发现术后 1 年胃内有植物性胃石。在内镜下进行碎片处理后,圈套器取出了胃石,患者后来接受了再次减重手术(LSG 转为 LRYGB)。

结论

随着全球 LSG 手术数量的增加,以及植物性胃石形成的迟发性,预计未来会发现更多此类并发症的病例。对接受 LSG 的患者进行长期术后随访并采用外科方法避免胃狭窄,有助于降低胃石形成的机会。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/def2/8141165/cb415397b047/12893_2021_1254_Fig1_HTML.jpg

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