Year 2023 / Volume 115 / Number 5
Letter
Challenge scenario: mid-gastric stenosis and gastric tube twist following laparoscopic sleeve gastrectomy

274-275

DOI: 10.17235/reed.2022.9185/2022

Ting-Yi Chu, Wan-Ting Hung, Guo-Shiou Liao, Kuo-Feng Hsu,

Abstract
The incidence of gastric stenosis, a complication of laparoscopic sleeve gastrectomy (LSG), has been reported to range from 0.7% to 4%. Only 1.1% of stenosis develop symptoms that require endoscopic or surgical intervention. We herein report a challenging case of mid-gastric stenosis and gastric tube twist following LSG. A 38-year-old woman with an initial body mass index (BMI) of 35 kg/m2 and metabolic syndrome undergoing LSG. A week after surgery, the patients developed intermittent vomiting and eating difficulty. Gastroscopy and following diagnostic laparoscopy were performed 3 weeks after LSG, subsequently revealing unusual mid-gastric stenosis and gastric tube twist. Initial conservative treatment and endoscopic balloon dilatation were implemented but failed. The patient received laparoscopic revisional Roux-en-Y gastric bypass and recovered well. A follow-up after 2 years revealed that her BMI decreased to 22.1 kg/m2. In conclusion, post-LSG stenosis is a serious complication that requires early detection and prompt management. Prompt revisional surgery is necessary for complicated stenosis.
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References
1. Rosenthal RJ, Diaz AA, Arvidsson D, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases. Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery. 2012;8(1):8-19.
2. Albanopoulos K, Tsamis D, Natoudi M, et al. The impact of laparoscopic sleeve gastrectomy on weight loss and obesity-associated comorbidities: the results of 3 years of follow-up. Surgical endoscopy. 2016;30(2):699-705.
3. Turcu F, Balahura C, Doras I, et al. Symptomatic Stenosis after Laparoscopic Sleeve Gastrectomy - Incidence and Management in a High-Volume Bariatric Surgery Center. Chirurgia (Bucharest, Romania : 1990). 2018;113(6):826-36.
4. Agnihotri A, Barola S, Hill C, et al. An Algorithmic Approach to the Management of Gastric Stenosis Following Laparoscopic Sleeve Gastrectomy. Obesity surgery. 2017;27(10):2628-36.
5. Termine P, Boru CE, Turcu F, et al. The impact of the surgical technique on stenosis after laparoscopic sleeve gastrectomy. Minerva surgery. 2021;76(1):43-9.
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Chu T, Hung W, Liao G, Hsu K. Challenge scenario: mid-gastric stenosis and gastric tube twist following laparoscopic sleeve gastrectomy. 9185/2022


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Publication history

Received: 05/09/2022

Accepted: 09/09/2022

Online First: 23/09/2022

Published: 05/05/2023

Article Online First time: 18 days

Article editing time: 242 days


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