Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Oct 16, 2023; 15(10): 629-633
Published online Oct 16, 2023. doi: 10.4253/wjge.v15.i10.629
Gallbladder plication as a rare complication of endoscopic sleeve gastroplasty: A case report
Cesar D Quiroz Guadarrama, Luis Andres Saenz Romero, Eric Misael Saucedo Moreno, Martín E Rojano Rodríguez
Cesar D Quiroz Guadarrama, Luis Andres Saenz Romero, Eric Misael Saucedo Moreno, Martín E Rojano Rodríguez, Obesity Clinic and Bariatric Surgery, Dr. Manuel Gea González General Hospital, México 14080, Mexico
Author contributions: Quiroz Guadarrama CD and Rojano Rodríguez ME conceived and designed the case report and performed the endoscopic and surgical procedures; Saenz-Romero LS collected all the data and recorded the imaging results related to the case; Saucedo Moreno EM performed analysis and interpretation of the data, drafted the report and reviewed the important concepts presented therein; All authors have read and approved the final manuscript.
Informed consent statement: We obtained the patient’s written informed consent to disclose this case. In the form, the patient has given her consent for her images and other clinical information to be reported in the journal. The patient understands that her name will not be published and due efforts will be made to conceal her identity.
Conflict-of-interest statement: All the authors declare having no conflicts of interest.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Eric Misael Saucedo Moreno, MCh, MMed, Associate Specialist, Obesity Clinic and Bariatric Surgery, Dr. Manuel Gea González General Hospital, Tlalpan 14080, Mexico, Mexico. eric.saucedo.m@gmail.com
Received: July 4, 2023
Peer-review started: July 4, 2023
First decision: August 16, 2023
Revised: August 30, 2023
Accepted: September 7, 2023
Article in press: September 7, 2023
Published online: October 16, 2023
Abstract
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.

Keywords: Gastroplasty, Bariatric surgery, Complication, Endoscopy, Case report

Core Tip: Only two cases have been reported worldwide of gallbladder plication as a major complication of endoscopic sleeve gastrectomy. We present the case of a 34-year-old patient who experienced right hypochondrium pain after endoscopic sleeve gastrectomy with a positive Murphy’s sign. Laboratory and imaging studies revealed acute cholecystitis findings and a possible gallbladder plication. Diagnostic laparoscopy confirmed plication of the Hartmann’s pouch wall to the stomach. A cholecystectomy was performed with a favorable outcome.