Year 2019 / Volume 111 / Number 12
Letter
Twisting of sleeve gastrectomy: two ways of clinic presentation

976

DOI: 10.17235/reed.2019.6366/2019

Clara Giménez Francés, Francisco Miguel González Valverde, Antonio Albarracín Marín-Blázquez,

Abstract
Laparoscopic sleeve gastrectomy is an increasingly widespread bariatric surgical technique thanks to its good outcomes and apparent simplicity. However, complications may arise, including hemorrhage, gastric fistula, and stenosis, which can be either organic or functional. Functional stenosis is caused by gastric tube twisting. We present two cases of patients who underwent laparoscopic sleeve gastrectomy and who were subsequently diagnosed with gastric twisting. Both cases required conversion to laparoscopic gastric bypass. Accompanying symptoms may vary but they commonly include early satiety, epigastric pain associated with food intake, gastroesophageal reflux and early vomiting. Although diagnose is mainly clinical, it requires high suspicion since endoscopy and gastrointestinal studies are not conclusive. The principal therapeutic options are endoscopic dilatations, serotomy and conversion to gastric bypass.
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References
1. Abd Ellatif ME, Abbas A, El Nakeeb A, et al. Management Options for Twisted Gastric Tube after Laparoscopic Sleeve Gastrectomy. Obes Surg. 2017;27(9):2404-9.
2. Iannelli A, Martini F, Schneck AS, et al. Twisted gastric sleeve. Surgery. 2015;157(1):163-5.
3. Contival N, Gautier T, Le Roux Y, et al. Stenosis without stricture after sleeve gastrectomy. J Visc Surg. 2015;152(5):339-41.
4. Arslan E BO, Sipahi M, Yagci G. Effects and Results of Omentopexy During Laparoscopic Sleeve Gastrectomy. Surg Laparosc Endosc Percutan Tech. 2018;28(3):174-7.
5. Espinet E, López-Nava B, Nebreda J et al. Spanish consensus document on bariatric endoscopy. Part 2: specific endoscopic treatments. Rev Esp Enferm Dig. 2019; 111(2):140-154.
doi: 10.17235/reed.2019.4922/2017.
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Giménez Francés C, González Valverde F, Albarracín Marín-Blázquez A. Twisting of sleeve gastrectomy: two ways of clinic presentation. 6366/2019


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Publication history

Received: 02/05/2019

Accepted: 05/06/2019

Online First: 22/11/2019

Published: 05/12/2019

Article revision time: 20 days

Article Online First time: 204 days

Article editing time: 217 days


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