Τίτλος:
Clinical Implications of Sleeve Gastrectomy as a Source of Spleen
Infarction or Ischemia
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
Splenic arterial demarcation has been observed during laparoscopic
sleeve gastrectomy (LSG). The present study aims to detect its actual
incidence during LSG and clarify its clinical significance. This is a
prospective observational study of 287 consecutive patients that
underwent LSG by the same surgical team over 3 years. In all patients,
the gastric fundus was mobilized using a standard technique. Before
withdrawal of the pneumoperitoneum, the spleen was exposed and carefully
inspected for evidence of arterial demarcation. Patients with a clear
demarcation were followed with Doppler ultrasound. Computed tomography
scan with oral contrast was performed to rule out septic complications.
Median preoperative body mass index was 46 kg/m(2) (range 35.1-78).
Median operative time was 58 min (range 42-185), median hospital stay
was 3 days (range 3-45), and overall morbidity rate was 8.6%.
Intraoperative demarcation of the upper splenic pole was evident in 12
patients (4.1%). Eleven patients had uneventful postoperative course.
One patient raised temperature of 38.5A degrees C at the 7th
postoperative day and was readmitted for further treatment. Once
afebrile, the patient was discharged on the 10th postoperative day and
continued on prophylactic low molecular weight heparin (tinzaparin,
7,500 U sc.) for 20 days. Splenic discoloration following LSG is an
uncommon complication with minimal clinical significance, which could be
related to hematoma, venous congestion, or ischemia. The possibility of
a late splenic abscess cannot be ruled out. No risk factors can be
identified preoperatively.
Συγγραφείς:
Stamou, Konstantinos M.
Menenakos, Evangelos
Gomatos, Ilias P.
and Panousopoulos, Sotirios-George D.
Smparounis, Spyridon and
Leandros, Emmanuel
Zografos, George
Περιοδικό:
Obesity Surgery
Λέξεις-κλειδιά:
Laparoscopic sleeve gastrectomy; Complications; Splenic discoloration;
Short gastric veins
DOI:
10.1007/s11695-010-0302-0
