Mohamed E Abd Ellatif1,2, Ashraf Abbas3, Ayman El Nakeeb4, Alaa Magdy5, Asaad F Salama6,7, Moataz M Bashah7, Ibrahim Dawoud3, Maged Ali Gamal8, Davit Sargsyan7. 1. Department of Surgery, Mansoura University Hospital, Gihan El Sadat St, Mansoura, Dakahlia, 35511, Egypt. surg_latif@hotmail.com. 2. Department of Surgery, Hafar Albatin Central Hospital, Hafar Al-Batin, Saudi Arabia. surg_latif@hotmail.com. 3. Department of Surgery, Mansoura University Hospital, Gihan El Sadat St, Mansoura, Dakahlia, 35511, Egypt. 4. Gastroenterology Surgical Center, Mansoura University, Mansoura, Dakahlia, 35511, Egypt. 5. Department of Surgery, Hafar Albatin Central Hospital, Hafar Al-Batin, Saudi Arabia. 6. Department of Surgery, Theodore Bilharz Research Institute, Cairo, Egypt. 7. Bariatric and Metabolic Surgery Center, Hamad Medical Corporation (HMC), Doha, Qatar. 8. Department of Surgery, Jahra Hospital, 01753, Al-Jahra, Kuwait.
Abstract
PURPOSE: This study aims to determine the incidence, etiology, and management options for symptomatic gastric obstruction caused by axially twisted sleeve gastrectomy. METHODS: In this retrospective study, we reviewed medical charts of all morbidly obese patients who underwent laparoscopic sleeve gastrectomy. Patients who developed gastric obstruction symptoms and were diagnosed with twisted sleeve gastrectomy were identified and included in this study. RESULTS: From October 2005 to December 2015, there are 3634 morbidly obese patients who underwent laparoscopic sleeve gastrectomy (LSG). Eighty-six (2.3%) patients developed symptoms of gastric obstruction. Forty-five (1.23%) patients were included in this study. The mean time of presentation was 59.8 days after surgery. Upper GI contrast study was done routinely, and it was positive for axial twist in 37 (82%) patients. Abdominal CT with oral and IV contrast was done in eight (18%) when swallow study was equivocal. Endoscopic treatment was successful in 43 patients (95.5%). Sixteen patients were successfully managed by endoscopic stenting, and 29 patients had balloon dilation. The average numbers of dilation sessions were 1.7. Out of these 29 patients, 18 responded well to a single session of dilatation and did not require any further dilatation sessions. Two patients who failed to respond to three subsequent sessions of balloon dilation underwent laparoscopic adhesiolysis and gastropexy. CONCLUSIONS: Endoscopic stenting is an effective tool in management of axial rotation of sleeved stomach. Balloon dilation can also be effective in selected cases. Few cases might require laparoscopic adhesiolysis and gastropexy.
PURPOSE: This study aims to determine the incidence, etiology, and management options for symptomatic gastric obstruction caused by axially twisted sleeve gastrectomy. METHODS: In this retrospective study, we reviewed medical charts of all morbidly obesepatients who underwent laparoscopic sleeve gastrectomy. Patients who developed gastric obstruction symptoms and were diagnosed with twisted sleeve gastrectomy were identified and included in this study. RESULTS: From October 2005 to December 2015, there are 3634 morbidly obesepatients who underwent laparoscopic sleeve gastrectomy (LSG). Eighty-six (2.3%) patients developed symptoms of gastric obstruction. Forty-five (1.23%) patients were included in this study. The mean time of presentation was 59.8 days after surgery. Upper GI contrast study was done routinely, and it was positive for axial twist in 37 (82%) patients. Abdominal CT with oral and IV contrast was done in eight (18%) when swallow study was equivocal. Endoscopic treatment was successful in 43 patients (95.5%). Sixteen patients were successfully managed by endoscopic stenting, and 29 patients had balloon dilation. The average numbers of dilation sessions were 1.7. Out of these 29 patients, 18 responded well to a single session of dilatation and did not require any further dilatation sessions. Two patients who failed to respond to three subsequent sessions of balloon dilation underwent laparoscopic adhesiolysis and gastropexy. CONCLUSIONS: Endoscopic stenting is an effective tool in management of axial rotation of sleeved stomach. Balloon dilation can also be effective in selected cases. Few cases might require laparoscopic adhesiolysis and gastropexy.
Authors: Michel Gagner; Mervyn Deitel; Traci L Kalberer; Ann L Erickson; Ross D Crosby Journal: Surg Obes Relat Dis Date: 2009-06-13 Impact factor: 4.734
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Authors: Luciana T Siqueira; Fernando Santa-Cruz; João Paulo Pontual; Maria Amélia R Aquino; Luca T Dompieri; Flávio Kreimer; Álvaro A B Ferraz Journal: Arq Bras Cir Dig Date: 2022-06-24
Authors: Álvaro A B Ferraz; José-Tarcísio Dias da Silva; Fernando Santa-Cruz; Maria-Améllia R Aquino; Luciana T Siqueira; Flávio Kreimer Journal: Obes Surg Date: 2020-07-14 Impact factor: 4.129