Karanam Venkata Pavan Kumar, Panchal Aarsh Mukeshbhai, Sepuri Suresh Kumar, Chalamarla Lakshmi Kumar, Ravula Phani Krishna
Department of Surgical Gastroenterology, Pace Hospitals, Hyderabad, India.
Department of Interventional Radiology, Pace Hospitals, Hyderabad, India.
J Metab Bariatr Surg. 2025 Aug;14(2):157-163. doi: 10.17476/jmbs.2025.14.2.157. Epub 2025 Aug 22.
Obesity affects about 39% of the global population, and bariatric surgery is a leading treatment option. As the number of primary bariatric procedures increases, so does the demand for revisional bariatric surgeries (RBSs), which are often more complex and associated with increased risks of complications. This case report details an unusual complication of RBS that surgeons should be aware of. A 41-year-old male patient with morbid obesity, after an initial sleeve gastrectomy, experienced weight regain due to gastric pouch dilatation and underwent conversion to mini-gastric bypass. Postoperatively however, he presented with recurrent left subhepatic abscess. Evaluation revealed left ductal leak from undersurface of liver as cause of recurrent liver abscess. Surgical intervention in the form of left lateral sectionectomy, resolved the symptoms. This case underscores the complexities and potential complications associated with RBS, highlighting the need for meticulous adhesiolysis between stomach and left liver during revisional gastric surgeries.
肥胖影响着全球约39%的人口，减肥手术是主要的治疗选择。随着初次减肥手术数量的增加，对减肥翻修手术（RBS）的需求也在增加，这类手术往往更为复杂，且并发症风险更高。本病例报告详细介绍了一种RBS的罕见并发症，外科医生应予以关注。一名41岁的男性病态肥胖患者，在初次接受袖状胃切除术后，因胃囊扩张出现体重反弹，随后接受了转为迷你胃旁路手术。然而，术后他出现了复发性左肝下脓肿。评估显示，肝脏下表面左肝管渗漏是复发性肝脓肿的原因。通过左外侧肝段切除术进行手术干预后，症状得到缓解。本病例强调了RBS相关的复杂性和潜在并发症，突出了在翻修胃手术期间对胃和左肝之间进行细致粘连松解的必要性。
