Sleeve Gastrectomy Case Study
Main text
Abstract
Background: Although sleeve gastrectomy provides a technically simple procedure with minimal effect on digestive tract it deprives the stomach of its ligaments of fixation which results in impairment of gastric functions, vomiting, axial gastric rotation in addition to bleeding or leakage from the stable line.
Aim: To study the effect of stable line fixation during sleeve gastrectomy.
Patients and Methods: This is a prospective randomized study using closed envelop method carried on 100 patient with morbid obesity who underwent laparoscopic sleeve gastrectomy(LSG) they were divided into two groups each is 50 patient group A underwent classic(LSG) with no fixation and group (B) with staple line fixation.
Results: patients
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Postoperative gastric axial rotation was detected in 6 patients all were in group (A).Those were diagnosed when suspected clinically by persistent vomiting, dysphagia, or refractory gastroesophageal reflux despite proton pump inhibitor treatment after the initial LSG, then it was confirmed by both upper gastrointestinal series and gastro endoscopy all were treated endoscopically ,all were functional stenosis no organic stricture was found.4 cases responded well to repeated dilatation using achalasia balloon dilator at an increasing pressure starting from 15-psi ,and the other 2 cases required stent deployment with a self-expandable metal stent for 3 weeks then stent was removed . No further intervention was needed in any of the patients. The case that was detected intraoperatively was in group B and so it was fixed with uneventful postoperative
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