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Late Gastric Perforations After Laparoscopic Fundoplication

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Abstract

Background

Late complications are rarely encountered after laparoscopic Nissen fundoplication. These complications include acute gastric herniation through the esophageal hiatus, port-site herniation, recurrent reflux, and anatomic failure of the fundoplication. Only three cases of late gastric perforation after laparoscopic Nissen fundoplication have been reported, all associated with intrathoracic wrap herniation.

Methods

We retrospectively reviewed all cases of gastric perforation after laparoscopic antireflux procedures performed between July 1991 and March 2002 by a single surgeon.

Results

In this series of 1,600 laparoscopic antireflux procedures, we found six delayed gastric fundal perforations occurring in three patients at 1, 41, 48, 51, 68, and 72 months after surgery. All the perforations were on the anterior wall of the fundus of the stomach and were distant from the stitches of the fundoplication. None of the perforations was associated with severe peritoneal contamination.

Conclusions

This series of late gastric fundal perforations in 0.2% of our patients after laparoscopic fundoplication may have been caused by medications, gastric stasis, ischemia, or a foreign body such as a stitch or Teflon pledget.

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Abbreviations

GERD:

gastroesophageal reflux disease

NSAID:

nonsteroidal anti-inflammatory drug

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Authors and Affiliations

  1. Department of Surgery, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, Florida

    Kevin L. Huguet, Ronald A. Hinder & Todd Berland

Authors
  1. Kevin L. Huguet
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  2. Ronald A. Hinder
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  3. Todd Berland
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Corresponding author

Correspondence to Ronald A. Hinder.

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Huguet, K.L., Hinder, R.A. & Berland, T. Late Gastric Perforations After Laparoscopic Fundoplication. Surg Endosc 21, 1975–1977 (2007). https://doi.org/10.1007/s00464-007-9367-9

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  • DOI: https://doi.org/10.1007/s00464-007-9367-9

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