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Management of Complications Related to Laparoscopic Adjustable Silicone Gastric Band
Rodrigo Arrangoiz,
Manuel Muñoz-Juárez,
Roger H. Pozzo,
Fernando Cordera,
Enrique Luque-de León,
Eduardo Moreno-Paquentin,
M. Ángel Sánchez-Pérez,
Efrain Cruz-González,
José David Hernández-Marín
Issue:
Volume 5, Issue 3, June 2017
Pages:
37-42
Received:
15 March 2017
Accepted:
5 April 2017
Published:
3 May 2017
Abstract: Laparoscopic adjustable silicone gastric band (LASGB) is frequently used to treat morbidly obese patients worldwide. Complications related to this procedure have increased as the follow-up interval of these patients has increased. Treatment of these complications often includes removal of the silicone band. Herein we report our experience with silicone gastric band removal, discuss the different treatment alternatives, and present a management algorithm. A retrospective review of complications related to LASGB was made from June of 2003 to April of 2010 (eight patients). Techniques of band extraction are discussed and a management algorithm is presented. The mean Body Mass Index at the time of LASGB placement was 39.45 (Range 34.2 - 42.8). The median patient’s age at the time of LASGB was of 32.6 years (range: 13 to 50 years). The average durability of the silicone band after laparoscopic placement was 67.8 months (range: 6 to 120 months). In three patients (37.5%) the LASGB had perforated the gastric wall and was therefore extracted using a transgastric approach (laparoscopic in two patients and by laparotomy in one patient). In five patients the silicone band had not perforated the stomach and was therefore removed laparoscopically without entering the stomach. The weight was recovered in 37.5% of the patients during follow-up. Management of patients with complications related to LASGB placement must be individualized and should address both the band related complication as well as the obesity problem. Laparoscopic trans-gastric band extraction is ideal when the LASGB has eroded into the stomach and endoscopic extraction is not feasible.
Abstract: Laparoscopic adjustable silicone gastric band (LASGB) is frequently used to treat morbidly obese patients worldwide. Complications related to this procedure have increased as the follow-up interval of these patients has increased. Treatment of these complications often includes removal of the silicone band. Herein we report our experience with sili...
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Gastric Outlet Obstruction Caused by a Triple Lesion: Eosinophilic Gastroenteritis, Brunner’s Gland Hyperplasia and Pancreatic Heterotopia in Unison
Apurva Sharma,
Sonmoon Mohapatra,
Kheng-Jim Lim,
Abhijeet Chaubal,
Arkady Broder
Issue:
Volume 5, Issue 3, June 2017
Pages:
43-46
Received:
1 March 2017
Accepted:
30 March 2017
Published:
3 May 2017
Abstract: Gastric outlet obstruction is a common entity described with numerous benign and malignant causes. Historically, benign causes include Peptic Ulcer disease (PUD); however recent cases have reported other causes including Eosinophilic Gastroenteritis (EGE), Brunner’s Gland Hyperplasia (BGH) and Pancreatic Heterotopia (PH). We present an unusual case of a 31 year old male patient with severe gastric outlet obstruction requiring surgical intervention caused by all three pathologies in unison – EGE, BGH and PH. The patient underwent surgical resection with distal gastrectomy and Billroth II reconstruction. Histology confirmed the three pathologies and post-operative recovery of the patient was uneventful.
Abstract: Gastric outlet obstruction is a common entity described with numerous benign and malignant causes. Historically, benign causes include Peptic Ulcer disease (PUD); however recent cases have reported other causes including Eosinophilic Gastroenteritis (EGE), Brunner’s Gland Hyperplasia (BGH) and Pancreatic Heterotopia (PH). We present an unusual case...
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Comprehensive Treatment of Advanced Liver Cancer Complicated with Upper Gastrointestinal Bleeding in Multidisciplinary Team Model: A Case Report
Liuming Lin,
Mingrong Cao,
Qiang Li,
Zhilong Liu
Issue:
Volume 5, Issue 3, June 2017
Pages:
47-52
Received:
20 April 2017
Accepted:
4 May 2017
Published:
31 May 2017
Abstract: A 44-year-old male was presented to emergency department because of repeated abdominal distension for 1 month, melena for 1 day and hematemesis for 4 hours. After examination, he was diagnosed with esophageal varices (III degree) and hemorrhage, primary massive hepatocellular carcinoma (cT3aN1Mx) and hepatitis B cirrhosis. In collaboration with the MDT team, this patient received a comprehensive treatment for up to 19 months which included surgical devascularization and cryoablation for liver cancer, TACE, SBRT, molecular targeted therapy, Chinese medicine treatment, antiviral therapy and so on. The latest review showed that liver cancer had distant metastasis, but the quality of life was still good. It seems that the comprehensive treatment of MDT is helpful for patients with HCC to improve the quality of life.
Abstract: A 44-year-old male was presented to emergency department because of repeated abdominal distension for 1 month, melena for 1 day and hematemesis for 4 hours. After examination, he was diagnosed with esophageal varices (III degree) and hemorrhage, primary massive hepatocellular carcinoma (cT3aN1Mx) and hepatitis B cirrhosis. In collaboration with the...
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Colonic Self-Expandable Metallic Stents for Patients with Colorectal Cancer Obstruction Induced Sepsis
Issue:
Volume 5, Issue 3, June 2017
Pages:
53-57
Received:
6 April 2017
Accepted:
27 April 2017
Published:
22 June 2017
Abstract: To determine whether using colonic self-expandable metallic stents (SEMS) as a bridge to surgery for patients with colorectal cancer obstruction induced sepsis (CRCOIS) have better health outcomes compared with emergency surgery (ES). The patients with CRCOIS were enrolled from three university hospitals in China and retrospectively divided into SEMS group (n=32) or ES group (n=20). A total of 52 patients met the inclusion criteria. SEMS group had less the incidence of deep vein thrombosis (P<0.01) and number of organ dysfunction (P<0.01) than ES group. Kaplan-Meier curve showed no significant difference is found in term of 360-day overall survival between the two groups (log-rank test, P = 0.12). However, Multivariable analysis showed the pathological stages (OR: 1.26, 95%CI: 0.72-1.63, P<0.01) and number of organ failure (OR: 0.95, 95%CI: 0.71-1.42, P<0.01) are independent risk factors for 360-day overall survival. Therefore, SEMS placement as a bridge to surgery followed by selective surgery is a feasible and safe procedure for patients with CRCOIS, provides significant advantages of prognosis such as reducing the length of hospital stay, and decreasing the incidence of deep venous thrombosis and organ dysfunction.
Abstract: To determine whether using colonic self-expandable metallic stents (SEMS) as a bridge to surgery for patients with colorectal cancer obstruction induced sepsis (CRCOIS) have better health outcomes compared with emergency surgery (ES). The patients with CRCOIS were enrolled from three university hospitals in China and retrospectively divided into SE...
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