Complications of gastric plication. Methods of prevention and correction methods

K.N. Militsa


Background. The relevance of the problem of obesity and metabolic syndrome, as well bariatric surgery as the most effective way to treat obesity and related metabolic disorders with long-term and stable result are without any doubt in the medical community. But the implementation of bariatric surgery in Ukraine is not too active due to the high cost of operations. In recent years, there have been developed new cheaper intervention methods. One of them is a laparoscopic longitudinal gastroplication. Therefore, the aim of this study was to study any complications of gastric plication, search for possibilities of their prevention and correction. Materials and methods. The study involved the results of 40 gastric plications. Long-term results were studied in 28 patients with follow-up from 1 to 4 years. Results. The most ubiquitous complication after the first 10 operation was swelling of the gastric mucous membrane caused complete gastrostasis. Much more rare complications were pseudodiverticulosis in plication areas in the body of the stomach; the expansion of gastric fundus; stricture of the stomach angle; stomach deplication. After the first 10 operations the technique was modified by increasing diameter of gastric tube to 12 mm. Suturing technique of the first row has been changed. The suture involves cross-linking the front and back walls of the stomach as well as a greater curvature of the stomach to form a single channel, which prevents the development of edema mucous obstruction. The article also describes the ways of correction of other complications that may arise after the gastric plication surgery. Conclusions. Laparoscopic gastric plication is worth getting widespread implementation into practical bariatrics. The unconditional advantages of gastric plication are the technical and economic availability, a small number of really preventable complications.


obesity; metabolic syndrome; bariatric surgery; gastric plication


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