Acute pancreatitis as an unusual early post-operative complication following laparoscopic sleeve gastrectomy

Sarwal, Ankush; Khullar, Rajesh; Sharma, Anil; Soni, Vandana; Baijal, Manish; Chowbey, Pradeep

doi:10.4103/jmas.jmas_169_17

Cited by 5 publications

(7 citation statements)

References 8 publications

(8 reference statements)

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“…The development of acute pancreatitis after bariatric surgery is probably associated with the manipulation of peripancreatic tissue intraoperatively. Secondarily, it may be related to the impaired pancreatic microcirculation after gastrectomy [ 28 ]. The diagnosis is made based on computed tomography.…”

Section: Early Complicationsmentioning

confidence: 99%

Complications associated with laparoscopic sleeve gastrectomy – a review

Woźniewska¹,

Diemieszczyk²,

Hady³

2021

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Laparoscopic sleeve gastrectomy (LSG) is an essential bariatric procedure performed in obese patients, which provides significant weight loss and has a positive impact on obesity-related diseases. However, as with any surgical procedure, it carries the risk of complications. The complications that can arise in patients following LSG are divided into acute (diagnosed within 30 days after the surgery) and late. Early complications that require rapid management include haemorrhage (intraluminal or extraluminal), leak in the staple line, and abscess formation. Late complications include gastric stenosis, nutrient deficiencies, mediastinal pouch migration, and the development or exacerbation of gastroesophageal reflux diseases. In this review, we present the basic information about most common complications following LSG, and their symptoms, diagnostic tools, and management.

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Section: Early Complicationsmentioning

confidence: 99%

Complications associated with laparoscopic sleeve gastrectomy – a review

Woźniewska¹,

Diemieszczyk²,

Hady³

2021

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“…A final, albeit theoretical, promotor of AP is the splenic infarction during the ligation of the short gastric vessels during LSG. Some authors believe that splenic infarction and secondary infection and resultant inflammation could add to the development of AP, primarily because of the poor collateral circulation in the area . Splenic vein thrombosis due to pancreatitis is much more common .…”

Section: Discussionmentioning

confidence: 99%

Pattern of Biliary Disease Following Laparoscopic Sleeve Gastrectomy in Adolescents

Tashiro

Thenappan

Nadler

2019

Obesity

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Objective The use of laparoscopic sleeve gastrectomy (LSG) has risen steadily as a treatment for adolescents with obesity. This study determined whether obstructive biliary complications after rapid, LSG‐related weight loss occur similarly in adolescents compared with adults. Methods Between 2010 and 2019, 309 patients underwent LSG. Demographics and clinical factors, including pre‐ and perioperative BMI and weight changes, were included. Results Overall, 21 patients (7%) had post‐LSG biliary disease (BD), of whom 13 presented with acute pancreatitis (AP) and 8 with biliary colic. No differences existed between those with BD (n = 21) and the remaining cohort (n = 288). Patients with BD were 16.3 (SD 2.4) years of age at LSG, with a preoperative BMI of 49.3 (SD 6.7) kg/m2. Preoperative excess BMI loss was 7.1% (SD 11.3%). An ultrasound revealed gallstones (71%) and sludge or crystals (12%). Eighteen patients underwent cholecystectomy between 4 weeks and 29 months after LSG. Conclusions Pediatric patients present with BD at a similar rate after LSG compared with adults. The majority of adolescents, however, manifest with AP. Thus, pancreatitis should be high on the differential diagnosis list when evaluating post‐LSG abdominal symptoms. Additional studies are warranted to elucidate the pathophysiology of post‐LSG AP for prevention in the future because its etiology may or may not be solely related to BD.

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“…Post-LSG complications are divided into an early complication (within 2 weeks) and a delayed complication (after 2 weeks). In the literature, pancreatitis has been rarely reported as an early complication of bariatric surgery [4].…”

Section: Discussionmentioning

confidence: 99%

“…The obesity prevalence in the Gulf countries was 5–14% and 3–18% among males and females, respectively [3]. Bariatric surgery is known to cause multiple complications including acute pancreatitis (AP), which is considered a late complication after laparoscopic sleeve gastrectomy (LSG) [4]. In the literature, limited data find about pancreatitis secondary to Mycophenolate Mofetil (MMF) and Tacrolimus (Tac), which are commonly used post-transplant immunosuppressants [5,10].…”

Section: Introductionmentioning

confidence: 99%

Immunosuppressant-induced late acute pancreatitis after laparoscopic sleeve gastrectomy: a case report and literature review

Alqahtani

Alali

Allehiani

2019

Journal of Surgical Case Reports

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Acute pancreatitis (AP) is a serious life-threatening condition, especially in high-risk patients. Limited data exist regarding early and late complications of immunosuppressant drugs as a cause of pancreatitis, especially Tacrolimus and Mycophenolate Mofetil (MMF), after transplantation. We report a rare case of late AP secondary to immunosuppressants’ synergistic effect after 5 years of renal transplant in an obese patient on day 4 after laparoscopic sleeve gastrectomy (LSG). We present a 41-year-old Saudi obese male patient, known to have multiple comorbidities and a renal transplantation twice, was on multiple medications, including Prednisolone, MMF and Tacrolimus for 5 years. On day 4 post-LSG, he developed severe epigastric abdominal pain and was diagnosed to have AP as a late complication of immunosuppressants’ synergistic effect. LSG is a common safe procedure, but complications related to medical illnesses or medications can occur. Careful review and sufficient knowledge of early and late complications are required.

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Acute pancreatitis as an unusual early post-operative complication following laparoscopic sleeve gastrectomy

Cited by 5 publications

References 8 publications

Complications associated with laparoscopic sleeve gastrectomy – a review

Complications associated with laparoscopic sleeve gastrectomy – a review

Pattern of Biliary Disease Following Laparoscopic Sleeve Gastrectomy in Adolescents

Immunosuppressant-induced late acute pancreatitis after laparoscopic sleeve gastrectomy: a case report and literature review

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