Small Bowel Obstruction Secondary to Intragastric Erosion and Migration of A Gastric Band

Egbeare, D.M.; Myers, Alistair; Lawrance, Richard

doi:10.1007/s11605-007-0304-y

Cited by 28 publications

(22 citation statements)

References 4 publications

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“…The timing of removal is debated, with some authors removing the band at any stage of migration and others advising a period of surveillance while the band completes its migration into the lumen of the stomach [22]. In our opinion, removal of the band is advisable as soon as the diagnosis is made because multiple reports demonstrate the real risk of adverse events during such ''surveillance'' [23,24].…”

Section: Discussionmentioning

confidence: 99%

Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years

et al. 2010

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The overall incidence of LAGB erosions in our series was 1.96%. This incidence fell with increasing experience to 0.5% after the initial 300 bands were excluded from the analysis (3 band erosions in the last 565 band insertions). However, further increases in incidence are likely with a longer follow-up period. The most common presentation was abdominal pain followed by weight regain and port-site sepsis. In the authors' hands, laparoscopic omental plugging and band removal through a separate anterior gastrotomy appear to be effective methods for dealing with band erosions. Band erosion is a significant source of morbidity, with at least one-third of the erosion patients in our series not achieving their final goal of weight loss despite appropriate treatment. This study highlights the need for a future prospective randomized study to clarify the apparent strong influence of band design and construction on the etiopathogenesis of band erosion.

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Section: Discussionmentioning

confidence: 99%

Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years

et al. 2010

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“…There has been a reported case of an eroded band migrating and causing small bowel obstruction. 6 An emergency laparotomy may be necessary in this situation. An alternative presentation is with weight re-gain as the band loses its restrictive effect.…”

Section: Band Erosionmentioning

confidence: 99%

Complications of Bariatric Surgery: Presentation and Emergency Management – a Review

Monkhouse

Morgan

Norton

2009

annals

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Ann R Coll Surg Engl 2009; 91: 280-286 280Obesity is a world-wide epidemic 1 and is associated with multiple serious co-morbidities, both physical and psychological. Over the last decade, there has been an exponential rise in the number of bariatric procedures being offered, 2 as these have consistently been shown to be the only way to achieve sustainable weight loss and improvement in comorbidities, particularly type II diabetes and hypertension. There are many different surgical operations available to achieve weight loss; the choice of surgery depends on a number of factors, not least the experience of the surgeon and the patient's individual requirements. The predominant operation performed in the UK is the laparoscopic adjustable gastric band (LAGB), which is a purely restrictive procedure. Other procedures incorporate a malabsorptive element and include the Roux-en-Y gastric bypass (RYGB) and the biliopancreatic diversion (with or without duodenal switch; BPD, BPD/DS; Fig. 1A). Other operations include sleeve gastrectomy (Fig. 1B) which can be used as a definitive procedure or as a bridge to further by-pass surgery, and the largely historic vertical banded gastroplasty. All surgery carries some degree of risk and the decision to operate is made after a careful balance of the risks versus the benefits. This particular group of patients often have limited physiological reserves and this, together with their physical size, may make the surgery high-risk. Early detection and appropriate management of complications is crucial to prevent long-term morbidity and mortality.This review highlights the main complications that the general surgeon on-call may encounter as an emergency and illustrates the appropriate management strategies.A full literature search was carried out using PubMED and the Cochrane Library. Relevant international articles published in the last 10 years were assessed. Keywords for search purposes included bariatric, surgery, complications, emergency and management. Band-related complications Dysphagia/band slippageImmediate postoperative dysphagia is seen in some patients following LAGB. This is usually due to excessive perigastric fat resulting in a tightly fitting band or to postoperative oedema. Complete dysphagia, even for saliva, may take up to 10 days to resolve. Postoperative intravenous steroids and a strict nil-by-mouth regimen appear to increase the resolution rate for the oedema and thus hasten recovery. These patients are often in-patients until postoperative dysphagia resolves and so it is late dysphagia that more commonly The prevalence of obesity surgery is increasing rapidly in the UK as demand rises. Consequently, general surgeons on-call may be faced with the complications of such surgery and need to have an understanding about how to manage them, at least initially. Obesity surgery is mainly offered in tertiary centres but patients may present with problems to their local district hospital. This review summarises the main complications that may be encountered. MATERIALS AND M...

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“…Besides our report, only a few cases have been published in PubMed-listed journals so far. 2,9,10 Other possible causes for gastrointestinal obstruction associated with laparoscopic gastric banding include erosion and retrograde migration to the gastroesophageal junction 18 or external stenosis due to the band tubing. 19 Uncomplicated erosion mostly is a non-life-threatening condition, and after disconnection of the port from the catheter, there are several therapeutic options, including laparoscopic 20 and endoscopic salvage or the "let loose technique," 21 to await natural passage of the band itself.…”

Section: Discussionmentioning

confidence: 99%

“…To the best of our knowledge, at present there are only 3 comparable cases available by a PubMed literature search. 2,9,10 We describe the case of a gastric band migration 12 years after implantation and 8 years after explantation of the port and catheter.…”

Section: Introductionmentioning

confidence: 99%

Jejunal Obstruction After Complete Transmural Gastric Band Migration

Primavesi

Jäger

Baschata

et al. 2014

CRSLS

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Introduction: Surgery for morbid obesity is constantly gaining popularity around the world, and laparoscopic adjustable gastric banding is among the most accepted standard procedures. Lately, growing evidence for long-term complications has been reported with this particular technique. While band erosion is described in ϳ1% of patients, complete transmural migration is scarce but may lead to acute intestinal obstruction.

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Small Bowel Obstruction Secondary to Intragastric Erosion and Migration of A Gastric Band

Cited by 28 publications

References 4 publications

Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years

Band erosion after laparoscopic gastric banding: a retrospective analysis of 865 patients over 5 years

Complications of Bariatric Surgery: Presentation and Emergency Management – a Review

Jejunal Obstruction After Complete Transmural Gastric Band Migration

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