A 15-year-old boy first presented with severe lung lesions and hypoxia and he was considered as a lung transplant candidate. Upon evaluation, hepatopulmonary syndrome, multiple nodular liver lesions, and Abernethy type 1b malformation were diagnosed. The patient underwent successful right lobe live donor liver transplantation, and all of the symptoms disappeared soon after the transplant. He is currently alive and well with excellent liver and lung functions 4 years after surgery.
Aim: Our aim was to emphasize an uncommon complication of sleeve gastrectomy. Material and Method: Sixty-two morbidly obese patients underwent laparoscopic sleeve gastrectomy. All patients were required to have psychological, routine laboratory examination, upper gastrointestinal endoscopy, pulmonary function studies and a medical evaluation. All patients were preoperatively evaluated by a dietician. The procedure was performed by a standard technique. Results: A total of 62 patients (43 females, 19 males) underwent laparoscopic sleeve gastrectomy. Four of the 62 patients (1 male, 3 female) were admitted with a complaint of nausea, vomiting and liquid intolerans 7 to 10 days after discharge. Upper gastrointestinal contrast swallov study revealed "Kinking"of the remnant stomach. Conclusion: Kinking is a complication to be known and rather than management, prevention of this complication must be supplied by further efforts.
Objective: The aim of this study was to demonstrate a lurking ligament and its various formation types and to mention the importance of this ligament in Laparoscopic sleeve gastrectomy Methods: One hundred and twelve patients had laparoscopic sleeve gastrectomy (LSG) procedure in our clinic between March 2011 and September 2013. All procedures were performed with a standard operative technique. Only difference for the last 50 patients was to avoid the excessive dissection of posterior gastric wall. The existence of posterior gastric ligament was recorded and different types of posterior gastric ligament was demonstrated. Results: Posterior gastric ligament was observed in all of the cases in different formation types. Three types of ligament; complete, partial and skippy, was demonstrated. 53(47.3%) of the patients had skippy, while 41 (36.6%) had partial and 18 (16.1%) had complete type of posterior gastric ligament. Conclusion: A ligament named as 'posterior gastric ligament' and its various forms were defined in the third dimensional plane of stomach. Posterior gastric ligament remains as the only structure in LSG for preventing the mobility and ability of the stomach to rotate. The excessive dissection of the posterior gastric ligament should be avoided to prevent complications such as kinking and volvulus
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