PDF(Pubmed)
Abstract：
Obesity is an important public health concern worldwide. In Saudi Arabia, the overall prevalence of obesity has increased in both men and women in recent decades. The laparoscopic approach to bariatric surgery was first reported in the 1990s, with laparoscopic adjustable gastric banding (LAGB) developed soon after. The performance of bariatric procedures has increased rapidly in recent years, with safety and efficacy data available for the surgical treatment of obesity and related metabolic disorders. Herein, we report a challenging condition of a female patient who underwent LAGB insertion in 2013. The patient presented with a complaint of a foreign body passing through her rectum during defecation that was manually pushed back by the patient. Radiological imaging and upper/lower endoscopy confirmed the diagnosis of complete gastric band erosion into the stomach, and the reservoir with the remaining tube was observed inside the colon near the splenic flexure. This case was complicated by complete band erosion and gastrointestinal (GI) fistula formation following the delivery of her second child in January 2022. Colonic band erosion is a rare complication of LAGB. Most patients with gastric band erosion are asymptomatic or exhibit nonspecific symptoms. The definitive management of gastric band erosion involves band removal. Several approaches are commonly used in clinical practice. In our case, the band was removed using a combined laparoscopic and endoscopic retrieval approach, which is the first such report in the literature.
摘要：
肥胖是世界范围内重要的公共卫生问题。在沙特阿拉伯,近几十年来，男性和女性肥胖的总体患病率都有所增加。20世纪90年代首次报道了腹腔镜减肥手术的方法，腹腔镜可调节胃束带术（LAGB）发展后不久。近年来，减肥程序的性能迅速提高，具有可用于肥胖和相关代谢紊乱的手术治疗的安全性和有效性数据。在这里，我们报告了2013年接受LAGB插入术的女性患者的一项具有挑战性的病情.患者在排便过程中出现异物通过直肠的抱怨，患者手动将其推回。放射学成像和上/下内窥镜检查证实了完全胃带侵蚀进入胃的诊断，在结肠内脾曲附近观察到带有剩余管的储液器。在2022年1月分娩第二个孩子后，该病例因完全束带侵蚀和胃肠道（GI）瘘形成而变得复杂。结肠带侵蚀是LAGB的罕见并发症。大多数胃束带糜烂患者无症状或表现出非特异性症状。胃束带侵蚀的最终处理包括去除束带。临床实践中常用的几种方法。在我们的案例中,使用腹腔镜和内窥镜联合取出方法去除带，这是文献中的第一份此类报告。
