Death-related gastric necrosis after Laparoscopic Adjustable Gastric Banding in the early post-operative period

Abstract

We report a case of a rare complication of Laparoscopic Adjustable Gastric Banding (LAGB) as a cause of death in the immediate post-operative period. The number of relevant reports and postmortem images presented in the literature is extremely restricted. Gastric necrosis may constitute a cause of death after LAGB in the early post-operative period. Postmortem examination reveals the extension of gastric ischemia and necrosis, responsible for the lethal outcome. To date, only one case of gastric necrosis after LAGB in the immediate post-operative period leading to death has been reported, according to authors' knowledge. The diagnosis of this complication may be delayed on the grounds of its rarity. In our opinion, surgeons should be aware of the clinical state implying gastric ischemia early after LAGB, so as to recognize and, in turn, to treat it promptly.

Emergency gastrectomy for gastric necrosis 5 years after laparoscopic adjustable gastric banding (LAGB)

“…All papers relevant to this study were reviewed and of these, 22 papers have been included in this study. The findings of the cases with gastric necrosis following LAGB including details of : a) reference #, b) author, c) study type, d) number of cases/patients reported, e) age and sex, f) time interval between LAGB and gastric necrosis, g) presenting symptoms, h) management, i) outcome and j) cause of the gastric necrosis are summarized in Table 1 [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16].…”

Autopsy following complications of bariatric surgery

“…Adjustable gastric banding can cause death via pressure necrosis of the stomach wall. 5 Liver cirrhosis-which can be caused by obesity as such-is associated with increased mortality resulting from major surgery, 6 and might be expected to contribute to death from BS. However, apart from one case in the NCEPOD series, this is not generally reported.…”

Stomach torsion in pregnancy as a complication of laparoscopic adjustable gastric banding

“…On literature review, only two cases of mortality in the early post-operative period were due to stomach necrosis as a complication of LAGB(5). …”