Thoracic Empyema After Laparoscopic Adjustable Gastric Banding. A Rare Complication

Abstract

The laparoscopic adjustable gastric banding (LAGB) is a popular therapeutic option for morbid obesity. It is a minimally invasive procedure. The reported early morbidity is low and there are only few reports of respiratory complications. We report a case of empyema and lung abscess due to diaphragm perforation by a LAGB.

Major respiratory adverse events after laparascopic gastric banding surgery for morbid obesity

“…Two patients were reported by Alamoudi 10 one with AP and the other case of pneumonia due to migration of a connecting catheter. A case of thoracic empyema was reported by Krassas et al 11 A case of recurrent AP after LAGB was reported by Hofer et al 12 Zimlichman et al 13 reported a case of lung abscess. Nemni 14 reported a case of severe chronic cough after LAGB without radiographic evidence of esophageal dilatation and with no response to medication.…”

Respiratory deterioration following laparoscopic adjustable gastric banding: A three-year follow-up of over 3,000 subjects

“…Neither study directly addressed the subject of post-operative pulmonary complications. Previous case series have tried to explain the association of LAGB with post-operative respiratory complications such as chronic cough [17,18], aspiration pneumonia [8,9,19], lung abscess [20,21], empyema [22], and bronchiectasis [10]. The leading hypotheses maintain that post-operative esophageal dilatation and dysmotility are responsible for both symptomatic and asymptomatic recurrent micro-aspirations of gastric secretions and contents, thereby causing inflammatory responses in the bronchial tree and lungs [5,6].…”

Aspiration-related organizing pneumonia complicating laparoscopic adjustable gastric banding: A lung cancer mimicker

“…Several studies have reported long-term pulmonary complications following LAGB, the most common of which are aspiration pneumonia, lung abscess, and empyema. [ 5 6 ] In most cases, the complications following LABG manifest 6 months to 3 years after gastric banding. [ 4 5 7 ] Interestingly, our patient developed organizing pneumonia 12 years after LAGB, experiencing nocturnal GERD due to a tight gastric band.…”

“…Previously examined patients with LABG-related aspiration pneumonia also reported GERD symptoms. [ 4 5 6 7 ] However, aspiration pneumonia rarely can be diagnosed in the absence of significant symptoms and when it is due to occult aspiration. [ 8 ]…”