Biliary peritonitis after endoscopic sutured gastroplasty for morbid obesity (with video)

Abstract

A 72-year-old man underwent endoscopic sleeve gastroplasty (ESG) for the treatment of morbid obesity (weight, 144 kg; body mass index, 48 kg/m2; hemoglobin A1C, 7.5%). He declined surgery. We performed ESG with the patient in the left lateral position and under general anesthesia, and we used CO2 insufflation. We adopted the oval-stitch pattern and approximated the anterior wall, greater curvature, and posterior wall of the gastric body using 5 suture plications (A, B). No adverse events occurred during the procedure.