ENDOSCOPIC REMOVAL OF AN ERODED ADJUSTABLE GASTRIC BAND

Usenko O. Y., Tereshkevich I. S., Todurov I. M., Kalashnikov O. O., Perekhrestenko O. V., Kosiukhno S. V., Plehutsa О. І., Potapov O. А.

CLINICAL AND EXPERIMENTAL MEDICINE

Scentific article

Abstract. Adjustable gastric banding (AGB) was one of the most popular bariatric procedure in the world in 2000- 2010. Despite its improved safety profile, AGB can cause unique complications that must be recognized and managed appropriately. One of the serious complications is the transgastric migration of the band. The occurrence of band erosion is reported in most long-term series of AGB, with a highly variable incidence ranging from 0,3 to 14%. This band should be extracted, although no general agreement exists about the best method for band removal. The aim of this study is to analyze the effectiveness and safety of endoscopic management of band erosion. Methods. Patients that developed band erosion were identified and clinical presentations, band characteristics and subsequent management were evaluated. Band erosion developed in 3 patients. Median preoperative BMI was 41,2±6,2 kg/m2 (range 37,3– 48,3 kg/m2). Average time to identification of erosion after AGB was 120±24 months (range 96–144 months). All patients had the same symptoms (abdominal pain and discomfort when eating (3/3), foreign body sensation (3/3), nausea (2/3), weight regain (3/3), reflux symptoms (3/3) and recurrent port infection in (1/3)). Result. The initial upper endoscopy found a migrated band more than half of the diameter in all cases. The computed tomography with 3D reconstruction has been improving the visualization and the ability to estimate the wall of gastric. The endoscopic cutting and removal of the band was completely successful for all patients. The median duration of the procedure was 143,3±38,2 min (range 110–185 min). Mean hospital stay was 2,7±0,6 days. Patients did well and were discharged with no complication. Conclusions. Endoscopic removal of eroded gastric bands after AGB is a safe and effective and should be considered the procedure of choice when treating this complication. It allows rapid recovery, permits a quick discharge of patients after the resumption of oral feeding, and avoids an operation.

obesity, adjustable gastric banding, band erosion, endoscopic management.

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«Bulletin of problems biology and medicine» Issue 2 (160), 2021 year, 139-143 pages, index UDK 616.33:616-072.1

10.29254/2077-4214-2021-2-160-139-143