Advances and future directions in endoscopic bariatric therapies

Table 4 Rare complications after endoscopic sleeve gastroplasty therapy

Number	Gender	Age	Initial BMI (kg/m2)	Complication	Timeframe	Adverse reaction	Measures	Symptoms	Ref.
1	Female	55	44.6	Stress urinary incontinence, back pain, and nephrolithiasis	During the operation	Dilated bowel loops and acute respiratory failure	High-flow nasal cannula oxygen therapy	Hypoxemia with abdominal distension	[75]
2	Female	34	30	None	1 months	Gallbladder folding secondary to ESG therapy	Laparoscopic cholecystectomy	Hematemesis, somnolence and positive Murphy’s sign	[76]
3	Female	31	Obesity (class I)	None	2 weeks	Liver abscess	Endoscopic drainage to gastric cavity	Epigastric pain and fever (39.3 °C)	[77]
4	Female	53	NA	None	1 days	Gastrointestinal symptoms and acute hypoxemic respiratory failure (7 days later)	Remove all sutures on post-op day 1; lovenox, apixaban and other supportive therapy	Refractory nausea, vomiting, abdominal pain, tachycardia and hypertension (BP 160/102 mmHg)	[78]
5	Female	40	NA	None	1 days	Intestinal obstruction with spontaneous resolution and pulmonary embolism (12 days later)	Apixaban and other supportive therapy	Severe epigastric pain, nausea and vomiting	[78]
6	Male	64	35.8	Hypertension, hyperlipidemia, and gastroesophageal reflux disease	9 hours	Gastric perforation	Exploratory laparotomy	Acute abdominal pain, abdominal distension and respiratory distress	[79]
7	Male	53	43.6	None	1 days	Umbilical hernia-induced small bowel obstruction, pneumoperitoneum and acute kidney injury	Emergent surgery	Abdominal pain, nausea and vomiting	[80]
8	Among 1000 enrolled patients: 924 (92.4%) experienced medication-controlled nausea or abdominal pain. Overall complication rate: 2.4% (24/1000), comprising: 8 cases of severe abdominal pain requiring intervention, 7 cases of postoperative hemorrhage, 4 cases of perigastric collection with pleural effusion and 5 cases of postoperative fever								[81]

BMI: Body mass index; NA: Not available; ESG: Endoscopic sleeve gastroplasty; BP: Blood pressure.