J Gastric Cancer.  2010 Jun;10(2):84-86.

Laparoscopic Surgery for Removal of the Multiple Large Gastric Bezoars

• Hong TH
• Kim JJ
• Park SM

Abstract

Bezoars are retained concretions of undigested animal or vegetable material that can produce gastrointestinal obstruction, ulceration, and bleeding. Therapeutic options for gastric bezoars include enzyme therapy (papain, cellulase, or acetylcysteine), endoscopic disruption and removal, and surgical removal. Multiple large gastric bezoars generally require conventional surgical management through an upper abdominal incision. With the recent improvement of laparoscopy, a lot of portions of abdominal operations have been performed laparoscopically. We successfully removed multiple large gastric phytobezoars in a 52-year-old female completely through laparoscopy. This supported the feasibility of laparoscopic surgery for patients with gastric bezoars.

Keyword

Gastric bezoar; Laparoscopy

MeSH Terms

Animals
Bezoars
Cellulase
Enzyme Therapy
Female
Hemorrhage
Humans
Laparoscopy
Middle Aged
Ulcer
Vegetables
Cellulase

Figure

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  Fig. 1 Gastroscopic finding. Gastroscopic finding showed multiple large gastric bezoar.

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  Fig. 2 Intraoperative view of laparoscopic removal for gastric bezoars. The bezoars were extracted through a gastrotomy on the anterior wall of the gastric body and placed directly in the endo-bag without any spillage.

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  Fig. 3 Specimens of fragmented bezoars. The bezoars were morcellated and removed in fragments.

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  Fig. 4 Intraoperative view of laparoscopic gastrotomy closure. The gastrotomy site was closed using endo-GIA staplers after the placement of stay sutures.

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