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Gallbladder plication as a rare complication of endoscopic sleeve gastroplasty: A case report
Cesar D Quiroz Guadarrama1, Luis Andres Saenz Romero1, Eric Misael Saucedo Moreno2
1Obesity Clinic and Bariatric Surgery, Dr. Manuel Gea González General Hospital, México 14080, Mexico.
Background:
Endoscopic sleeve gastroplasty (ESG) is a minimally invasive procedure used in the treatment of obesity, with a complication rate of less than 2% of cases. There have been only two reported cases worldwide of gallbladder injuries as a major complication of ESG.
Case Summary:
We present the case of a 34-year-old patient who developed a complication after ESG. The patient experienced epigastric and right hypochondrium pain 12 h after the procedure, and a positive Murphy's sign was identified on physical examination. Laboratory results showed a leukocyte count of 17 × 103/µL, and computed tomography indicated the presence of free fluid in the pelvic cavity and perihepatic recesses as well as a possible suture in the wall of the Hartmann's pouch toward the anterior surface of the stomach. A diagnostic laparoscopy was performed, revealing plication of the Hartmann's pouch wall to the anterior stomach wall. Laparoscopic cholecystectomy and lavage were carried out. The patient had a stable recovery and was discharged 72 h after surgery, tolerating oral intake.
Conclusion:
Gallbladder plication should be suspected if signs and symptoms consistent with acute cholecystitis occur after ESG.
