Late gastric pouch necrosis after Lap-Band®, treated by an individualized conservative approach

Mirto Foletto, Francesco De Marchi, Paolo Bernante, Luca Busetto, Fabio Pomerri

Research output: Contribution to journalArticlepeer-review

Abstract

Late band slippage has occurred in nearly 3-10% of patients after laparoscopic adjustable gastric banding (LAGB) with an average delay of 13 months. Band slippage can rarely lead to necrosis of the enlarged pouch, a potentially life-threatening condition. We report a female (BMI 39.92 with co-morbidities) who developed acute outlet obstruction 2 years after LAGB placement. After prompt band deflation, an urgent Gastrografin® swallow showed stomach slippage without emptying. At re-operation pouch strangulation was discovered. The pouch appeared to be ill-fated, but as no tear was evident on intra-operative assessment, we decided to simply remove the band and drain. The patient was successfully discharged after 8 days, and the last upper endoscopy showed only a large ulcer in the fundus that was healing. Proper and prompt management of symptomatic patients with stomach slippage, with early operation when acute obstruction is evident, can enable a successful stomach-sparing approach.

Original languageEnglish
Pages (from-to)1487-1490
Number of pages4
JournalObesity Surgery
Volume15
Issue number10
DOIs
Publication statusPublished - Nov 2005

Keywords

  • Adjustable banding
  • Laparoscopy
  • Morbid obesity
  • Surgical complication

ASJC Scopus subject areas

  • Surgery

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