1701 A Systematic Review of The Use of Stents in The Treatment of Bariatric Surgery Complications

41 retrospective observational studies were identified of 792 obese and super obese patients treated with endoscopic stents for bariatric surgery complications including leaks (n = 770) and strictures (n = 22) post-Roux en Y gastric bypass (n = 228) and sleeve gastrectomy (n = 534). The main outcomes of the studies were the percentage success of stent therapy and percentage stent migration. Stents included self-expanding metal stents (SEMS), including partially covered self-expanding metal stents (PcSEMS) and fully covered self-expanding metal stents (FcSEMS). Several SEMS used were specifically designed for bariatric complications, being larger in diameter to reduce migration. The pooled percentage success for all patients (SG and RYGB) was 80.81% with stent migration occurring in 24.67% in all groups. The pooled percentage success for the RYGB group was 80.28% and in the LSG group was 85.86% with percentage migration occurring in 20.65% and 23.82% respectfully.

Obstrucción intestinal, complicación inusual por banda gástrica ajustable laparoscópica: reporte de caso

Background: The main goal of bariatric surgery is the reduction of Body mass index (BMI). Laparoscopic adjustable gastric band (LAGB) was the most popular method due to its relative advantages over others. Clinical case: A 44-year-old woman with abdominal pain and distension, with a history of LAGB placement had a diagnosis of intestinal occlusion secondary to a twist in the device tube, surgical management was given, the patient presented adequate evolution. Conclusion: The occlusion of the small intestine by the tube of the device is a serious and uncommon complication to be considered as a differential diagnosis in bariatric patients. Keywords: Bariatric surgery; complications; gastric band; bowel obstruction; obesity.

Endoscopic Diagnosis and Treatment of Bariatric Surgery Complications

Obesity has become a health problem that generates significant expenses for the health system worldwide. It is associated with chronic diseases—such as high blood pressure and diabetes—and some types of cancers. Bariatric surgery is the gold standard in the treatment of morbid obesity. Several endoscopic procedures have emerged to treat the complications of these surgeries in a less invasive way, reducing morbidity and mortality in these patients. This review aims to present the best trend in the endoscopic treatment of bariatric surgery complications.

Gastric Bypass Reversion with Henley-Longmire Intestinal Loop, Surgical Treatment of Recurrent Marginal Ulcer - A Case Report

Bariatric surgery complications are associated with the nature of the procedure, reaching an incidence of 40%. One of them is the marginal ulcer, which is defined as a peptic ulcer produced over the jejunal mucosa, distal from the gastro-jejunal anastomosis. Its reported frequency ranges from 0.6 to 25% in gastric bypass patients. Associated risk factors are bad tissue perfusion by increased tension of the anastomosis, foreign bodies as stiches or staples, acidic exposure from gastric fistula, non-steroid anti-inflammatory drugs, tobacco and infection by Helicobacter Pylori. Female patient operated with Roux en “Y” Gastric bypass for obesity, 7 months after the first surgery she required emergency surgery with laparotomy due to postsurgical complications. 3 months after this event she was diagnosed with malnutrition and almost 1 year after the initial GB she presented to the ER with abdominal pain, distension and involuntary muscle resistance. She was admitted to the ER with tachycardia, bilateral hypoventilation and abdominal pain. A CT-scan revealed hollow viscera perforation. Pouch gastrectomy and anastomosis of the gastric remnant with the Henley-Longmire jejunal loop technique for reverse bypass procedure was performed successfully. The gastric bypass reversion is essential for long term complications that do not respond to initial treatment, such as the recurrent marginal ulcers, dumping syndrome, hiatal hernias, refractory hypoglycemia’s, nesidioblastosis, and hypocalcemia.