Introduction: morbid obesity is a chronic disease, with resistance to multiple therapies. Bariatric surgery is the most efficient nowadays treatment, but with a certain price when we speak of surgeon’s efforts, patient’s compliance and tolerance, available technology and long term evolution. Materials: we present the case of 20 years evolution of a female obese patient, with multiple, sequential bariatric minimally-invasive interventions: intragastric balloon, gastric banding, gastric bypass (GBP), banding positioning on GBP, all complicated. Last attempt to treat weight regain was laparoscopic positioning of an adjustable banding over a failed gastric bypass in 2015, complicated 12 months after by acute intestinal occlusion due to band migration, leading to open emergency band removal, wound dehiscence and finally incisional hernia. Results: after multiple interventions, the patient has a BMI of 38 kg/m2, large incisional hernia, depression, over a non-satisfactory gastric bypass. Conclusion: bariatric surgery has some limitations in case of patient’s non-compliance and bad-luck, even with persistent, experienced tailored bariatric treatment. Non-responsive obese patients should be considered as possible subcategory of long-term outcomes.
Unpredictable evolution of a 20-years history of a bariatric patient. Case report of a migrated gastric band after redo gastric bypass / Boru, Cristian Eugeniu; Manzia, Tommaso; Iossa, Angelo; Silecchia, Gianfranco. - In: OBESITY SURGERY. - ISSN 0960-8923. - 28:S1(2018), pp. 110-110.
Unpredictable evolution of a 20-years history of a bariatric patient. Case report of a migrated gastric band after redo gastric bypass
Boru, Cristian Eugeniu;Iossa, Angelo;Silecchia, Gianfranco
2018
Abstract
Introduction: morbid obesity is a chronic disease, with resistance to multiple therapies. Bariatric surgery is the most efficient nowadays treatment, but with a certain price when we speak of surgeon’s efforts, patient’s compliance and tolerance, available technology and long term evolution. Materials: we present the case of 20 years evolution of a female obese patient, with multiple, sequential bariatric minimally-invasive interventions: intragastric balloon, gastric banding, gastric bypass (GBP), banding positioning on GBP, all complicated. Last attempt to treat weight regain was laparoscopic positioning of an adjustable banding over a failed gastric bypass in 2015, complicated 12 months after by acute intestinal occlusion due to band migration, leading to open emergency band removal, wound dehiscence and finally incisional hernia. Results: after multiple interventions, the patient has a BMI of 38 kg/m2, large incisional hernia, depression, over a non-satisfactory gastric bypass. Conclusion: bariatric surgery has some limitations in case of patient’s non-compliance and bad-luck, even with persistent, experienced tailored bariatric treatment. Non-responsive obese patients should be considered as possible subcategory of long-term outcomes.File | Dimensione | Formato | |
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Note: https://link.springer.com/article/10.1007/s11695-018-3200-5
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