scholarly journals Cervical esophageal perforation caused by the use of bougie during laparoscopic sleeve gastrectomy: a case report and review of the literature

BMC Surgery ◽  
2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Andrea Lovece ◽  
Ioannis Rouvelas ◽  
Masaru Hayami ◽  
Mats Lindblad ◽  
Andrianos Tsekrekos
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Esophageal Perforation ◽  
Fluid Collection ◽  
Muscle Flap ◽  
Adequate Treatment ◽  
First Case ◽  
Relative Safety ◽  
Class 1 ◽  
Cervical Esophageal Perforation

Abstract Background Obesity is considered a chronic disease with an increasing prevalence worldwide during the last decades. Laparoscopic sleeve gastrectomy is the most commonly performed bariatric procedure, due to its relative safety and long-term efficacy. The use of bougie to ensure correct size of the gastric tube is part of the standard operation, usually placed by the anesthesiologist and with a very low rate of complications. We report the first case, to our knowledge, of a cervical esophageal perforation caused by the use of bougie during laparoscopic sleeve gastrectomy. Case presentation The complication occurred in a previously healthy 42-year old female patient who underwent laparoscopic sleeve gastrectomy for class 1 obesity (BMI 31 kg/m2) and was diagnosed the first post-operative day. She was subsequently treated with an emergency thoracoscopy and evacuation of a mediastinal fluid collection, with additional neck incision for primary closure of the esophageal defect which was reinforced with a sternocleidomastoid muscle flap. The post-operative course was uneventful. Conclusions We made a literature review to better understand the options considering the diagnosis and treatment in case of very proximal iatrogenic esophageal perforations. The risks related to the use of bougie during surgery should not be underestimated, and its insertion must be done with extreme caution. Esophageal perforation is still a challenging, life threatening complication where prompt diagnosis and adequate treatment are essential.

scholarly journals Lower oesophageal peptic stricture after laparoscopic sleeve gastrectomy: World's first case report

2020 ◽  
Vol 16 (3) ◽  
pp. 282
Author(s):  
Shivanshu Misra ◽  
PalaniveluPraveen Raj ◽  
Siddhartha Bhattacharya ◽  
SSaravana Kumar ◽  
TS Ramesh Kumar ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Case Report ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Peptic Stricture ◽  
First Case

scholarly journals Endoscopic management of esophageal perforation caused by calibrating bougie during laparoscopic sleeve gastrectomy

2017 ◽  
Vol 3 (2) ◽  
pp. 13 ◽  
Author(s):  
Gennaro Martines ◽  
Rosa Digennaro ◽  
Michele De Fazio ◽  
Palma Capuano
Keyword(s):  
Intensive Care Unit ◽  
Intensive Care ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Esophageal Perforation ◽  
Surgical Techniques ◽  
Endoscopic Management ◽  
Conservative Approach ◽  
Dedicated Team ◽  
Clinical Conditions

Background: Laparoscopic Sleeve Gastrectomy (LSG) is one of the most used surgical techniques for the treatment of morbid obesity. The esophageal perforation (EP) secondary to the use of calibrating bougie is a rare complication.Case presentation: A 43-year-old woman with a body mass index (BMI) of 54 kg/m2 underwent LSG. During the use of a calibrating bougie, a distal EP occurred, but it became evident only during the second day after the surgery. The patient was hospitalized in Intensive Care Unit because of respiratory failure and her clinical conditions did not permit a safe surgical treatment. The EP was treated successfully by endoscopic conservative approach with a double-covered self-expanding endoprosthesis (SEMS).Results: The esophageal calibrating bougie, often placed by an anaesthesiologist, is undoubtedly useful during the learning curve of the surgeon to ensure a correct sleeve size; however, it may result in severe and difficult-to-treat iatrogenic lesions.Conclusions: Managing the complications through conservative endoscopy is possible, but in order to support these patients, the immediate availability of an intensive care unit is essential. We underline the importance of a dedicated team of surgeons and anaesthesiologists and a multidisciplinary team to treat major complications in bariatric surgery.

scholarly journals Esophageal perforation during laparoscopic sleeve gastrectomy: Complication of bougie insertion

2021 ◽  
Vol 81 ◽  
pp. 105793
Author(s):  
Seyed Mohammad Kazem Tadayon ◽  
Nader Moeinvaziri ◽  
Masoud Amini ◽  
Maryam Setoodeh ◽  
Neda Haghighat
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Esophageal Perforation

scholarly journals Computed Tomography-based Diagnosis of Post-laparoscopic Sleeve Gastrectomy Gastric Leak

2020 ◽  
Vol 10 ◽  
pp. 8 ◽  
Author(s):  
Sultan R. Alharbi
Keyword(s):  
Computed Tomography ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Sensitivity And Specificity ◽  
Fluid Collection ◽  
Gas Content ◽  
Gastric Leak ◽  
Oral Contrast ◽  
Ct Findings ◽  
Good Diagnostic Accuracy

Objective: Gastric leak post-laparoscopic sleeve gastrectomy may appear as a variety of computed tomography (CT) findings. We aimed to review the various CT findings sensitivity and specificity in confirmed cases of gastric leak. Materials and Methods: A retrospective review was performed for all patients who underwent sleeve gastrectomy, CT, and endoscopy for suspected leak between 2011 and 2018. All patients with positive CT findings for gastric leak were included in the study. Results: A total of 152 consecutive patients underwent CT for suspected post-sleeve gastrectomy gastric leak. Out of 152 patients, 88 had positive CT findings for gastric leak and underwent endoscopy. The CT findings sensitivity and specificity of perigastric collection without oral contrast leak were 61% and 88.8%, oral contrast leak were 28% and 100%, and gas leak were 10% and 77.7%, respectively. Conclusions: Perigastric fluid collection without contrast leak and with variable wall enhancement and gas content is the most common CT findings of post-sleeve gastrectomy gastric leak. Among various CT findings, it exhibits good diagnostic accuracy with 61% sensitivity and 88.8% specificity.

scholarly journals Esophageal Perforation After Laparoscopic Sleeve Gastrectomy and Paraesophageal Hernia Repair Managed by Transhiatal Drainage

2019 ◽  
Vol 104 (9-10) ◽  
pp. 480-484
Author(s):  
Sunu Philip ◽  
Kerry Kole
Keyword(s):  
Sleeve Gastrectomy ◽  
Hernia Repair ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Esophageal Perforation ◽  
Paraesophageal Hernia ◽  
Staple Line ◽  
Paraesophageal Hernia Repair ◽  
Risk Patients ◽  
Staple Line Leakage ◽  
Laparoscopic Assisted

Laparoscopic sleeve gastrectomy (SG) was first established as a 2-stage procedure in high-risk patients undergoing gastric bypass or biliary pancreatic diversion with duodenal switch. It has since become increasingly used as a primary bariatric procedure. The 2 significant postoperative complications after this procedure are anastomotic staple line leakage or bleeding. True esophageal leaks after sleeve gastrectomy are extremely uncommon. We present a case of contained esophageal perforation after a laparoscopic sleeve gastrectomy and paraesophageal hernia repair managed successfully with laparoscopic-assisted transhiatal drainage. We review the literature on the management of this uncommon but highly morbid complication in patients undergoing bariatric surgery.

scholarly journals First Case Report of Fulminant Hepatitis After Laparoscopic Sleeve Gastrectomy Associated with Concomitant Maximal Therapeutic Dose of Acetaminophen Use, Protein Calorie Malnutrition, and Vitamins A and D, Selenium, and Glutathione Deficiencies

2020 ◽  
Author(s):  
Alyaa Abusabeib ◽  
Walid El Ansari ◽  
Jassim Alobaidan ◽  
Wahiba Elhag
Keyword(s):  
Weight Loss ◽  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Nutritional Deficiencies ◽  
Rapid Weight Loss ◽  
Nonalcoholic Fatty Liver ◽  
Protein Calorie Malnutrition ◽  
First Case ◽  
Liver Functions ◽  
Therapeutic Doses

Abstract Nonalcoholic fatty liver disease (NAFLD) is increasingly being linked to obesity. Although laparoscopic sleeve gastrectomy (LSG) is effective for weight loss that can ultimately resolve NAFLD, an initial transient deterioration of liver functions could be observed during the first few months post-operatively, after which a subsequent improvement of the liver functions might occur. Rapid weight loss, nutritional deficiencies, and protein malnutrition can all contribute to hepatic dysfunction and can affect the metabolism of medications such as acetaminophen leading to more insult to a compromised liver. We report acute liver failure after LSG associated with protein calorie malnutrition, multiple nutritional deficiencies in addition to concomitant use of therapeutic doses of acetaminophen. Treatment with N-acetylcysteine, and replacement of deficient multivitamins and trace elements resulted in significant improvement in liver functions.

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