Gyimesi György, Kormann Stefan, Müller Markus, Müller Dominik, Sulz Michael Christian
Department of Medical Diagnostics, Spital Thurgau AG, Münsterlingen, Switzerland.
School of Doctoral Studies, Semmelweis University, Budapest, Hungary.
AME Case Rep. 2025 Jun 19;9:78. doi: 10.21037/acr-24-240. eCollection 2025.
Laparoscopic adjustable gastric banding is a safe and effective method in bariatric surgery. Complications, which are relatively rare (10-20%), are related either to the band such as band slippage, pouch dilation, band erosion, intraluminal band migration or to the port-adjustment-tube system such as infection, tube disconnection and dislocation. Dislocation of the adjustment catheter perforating into the colon is extremely rare, our present case is the third publication on this complication.
In our present case, we report on an asymptomatic patient with intraluminal penetration of the dislodged adjustment tube into the colon 26 years after implantation of a gastric banding system. We revealed the complication randomly by positron emission tomography-computed tomography (PET-CT) in the course of a tumor staging of a newly diagnosed lung cancer. The gastric band was removed laparoscopically, the adjustment tube however, had to be cut through due to extended adhesions and could only partially be removed. The rest of the catheter passed spontaneously via rectum on the following day.
Intraluminal penetration of the dislodged adjustment tube into the colon is extremely rare and may be asymptomatic such as in case of our patient. Other relevant complications after gastric band implantation may also remain undetected. During long-term follow up, occasionally performed imaging should be considered also in asymptomatic patients with implanted gastric banding system.
腹腔镜可调节胃束带术是一种安全有效的减肥手术方法。并发症相对少见（10%-20%），与束带相关，如束带滑脱、胃囊扩张、束带侵蚀、管腔内束带移位，或与端口调节管系统相关，如感染、管道断开和脱位。调节导管穿入结肠的脱位极为罕见，我们目前的病例是关于这一并发症的第三篇报道。
在我们目前的病例中，我们报告了一名无症状患者，在植入胃束带系统26年后，移位的调节管管腔内穿入结肠。在对新诊断的肺癌进行肿瘤分期过程中，我们通过正电子发射断层扫描-计算机断层扫描（PET-CT）偶然发现了这一并发症。腹腔镜下切除了胃束带，但由于粘连广泛，调节管只能切断，仅部分取出。次日，导管其余部分自行经直肠排出。
移位的调节管管腔内穿入结肠极为罕见，可能无症状，如我们的患者。胃束带植入后的其他相关并发症也可能未被发现。在长期随访中，对于植入胃束带系统的无症状患者，也应考虑偶尔进行影像学检查。
