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腹腔镜可调胃束带术后乙状结肠绞窄导致肠梗阻。

Bowel obstruction by sigmoid strangulation as complication after laparoscopic adjustable gastric banding.

机构信息

Department of Digestive Surgery, IRIS Hospitals South, Université Libre de Bruxelles, Brussels, Belgium.

Department of Radiology, IRIS Hospitals South, Université Libre de Bruxelles, Brussels, Belgium.

出版信息

Acta Chir Belg. 2024 Aug;124(4):307-311. doi: 10.1080/00015458.2023.2234146. Epub 2023 Jul 10.

Abstract

BACKGROUND

Laparoscopic adjustable gastric banding (LAGB) has been widely performed in the past, however, given its limited weight loss compared to some other procedures, this technique is less often used. Furthermore, a number of complications leading to band removal have been reported in the past few years.

METHODS

We present a late acute bowel obstruction by sigmoid strangulation in a female patient with the LAGB performed 15 years ago.

RESULTS

The laparoscopic exploration displayed a post-LAGB intestinal strangulation of the sigmoid loop which was caused by the connecting tube. Since the bowel was still viable, the tube was cut and the obstruction has been successfully resolved. The patient was discharged three days after the surgery.

CONCLUSION

Although less often performed, knowledge of LAGB complications can be of importance. We believe that, the present strangulation of the sigmoid by the LAGB tubing is the world's first ever case reported. Nevertheless, when it is still proposed to selected patients, an adequate length of the intra-abdominal tubing could reduce the risk of loop formation and prevent this kind of obstruction by internal hernia.

摘要

背景

腹腔镜可调节胃束带术(LAGB)在过去已经得到广泛应用,然而,与其他一些手术相比,其减肥效果有限,因此该技术的应用越来越少。此外,过去几年中已经报道了一些导致带移除的并发症。

方法

我们报告了一位 15 年前接受 LAGB 的女性患者出现迟发性急性乙状结肠绞窄。

结果

腹腔镜探查显示 LAGB 后乙状结肠环发生肠绞窄,原因是连接管所致。由于肠仍有活力,因此切断了管子,成功解决了梗阻。患者在手术后三天出院。

结论

尽管 LAGB 并发症的发生频率较低,但了解这些并发症仍然很重要。我们认为,本次 LAGB 管导致的乙状结肠绞窄是世界首例报告。尽管如此,当仍然向选择的患者提出这种治疗方案时,足够长度的腹腔内管可以降低肠环形成的风险,并防止这种内疝引起的梗阻。

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