Laparoscopic gastric bypass complicated by gastric pouch necrosis: considerations in gastroesophageal reconstruction.
Gastric pouch necrosis and intraabdominal sepsis is an uncommon complication following laparoscopic gastric bypass. The intraoperative management of this complication centers on resection of the necrotic pouch, esophageal diversion, drainage, and enteral access for nutrition. Reestablishing gastrointestinal continuity at a later surgery following this complication can be challenging. We present a case in which the colon was found to be unacceptable for use in reconstruction; the remaining stomach was used as the conduit for a transhiatal reconstruction of gastrointestinal continuity instead.
Rundall
Brian K
BK
Department of Surgery, University of Virginia School of Medicine, Charlottesville, Virginia 22908-0679, USA.
Denlinger
Chadrick E
CE
Parrino
Gene P
GP
Foley
Eugene F
EF
Jones
David R
DR
D000328:Adult; D000714:Anastomosis, Surgical / Q000009:adverse effects; D004322:Drainage; D004750:Enteral Nutrition; D004946:Esophagostomy; D004947:Esophagus / Q000601:surgery; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D005774:Gastrostomy; D006801:Humans; D007582:Jejunostomy; D007583:Jejunum / Q000601:surgery; D010535:Laparoscopy / Q000009:adverse effects; D009336:Necrosis; D012086:Reoperation; D013270:Stomach / Q000473:pathology* / Q000601:surgery; D017792:Surgical Stapling; D013530:Surgical Wound Infection / Q000209:etiology / Q000601:surgery