Abstract
Erosion is an uncommon but feared late complication of adjustable gastric banding for morbid obesity. A high index of clinical suspicion is required, since symptoms are usually vague and nonspecific. Diagnosis is confirmed on upper gastrointestinal endoscopy and band removal is the mainstay of treatment, with band revision or conversion to other bariatric modalities at a later stage. Duodenal erosion is a much rarer complication, caused by the connection tubing of the band. We present our experience with a case of simultaneous gastric and duodenal erosions, managed by laparoscopic explantation of the band, primary suture repair of the duodenum, and omentopexy.
Highlights
Laparoscopic adjustable gastric banding (LAGB) is a wellestablished restrictive procedure, still popular among many bariatric surgeons, because of its adjustability, reversibility, and preservation of gastrointestinal tract continuity [1,2,3,4]
We present our experience with a case of simultaneous gastric and duodenal erosions, caused by the band and the connection tubing, respectively
LAGB is generally considered a safe procedure, with less postoperative complications compared to other bariatric operations, which require more extensive dissections and anastomoses
Summary
Laparoscopic adjustable gastric banding (LAGB) is a wellestablished restrictive procedure, still popular among many bariatric surgeons, because of its adjustability, reversibility, and preservation of gastrointestinal tract continuity [1,2,3,4]. While perioperative complications are minimal, compared to other bariatric modalities, it has a relatively high reoperation rate. Recent reviews, studying long-term results and complications, reveal a failure rate between 10 and 20% in the short run and 40% in the long run and an incidence of 12–48% of device-related complications [3]. These include early (band obstruction, gastric perforation, wound infection, and bleeding) and late (band slippage, pouch enlargement, port/tubing complications, and gastric erosion) complications, leading generally to unacceptable weight loss rates and requiring revision or conversion to other modalities [3]. We present our experience with a case of simultaneous gastric and duodenal erosions, caused by the band and the connection tubing, respectively
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