Anatomy and Complications Following Laparoscopic Sleeve Gastrectomy: Radiological Evaluation and Imaging Pitfalls.
Summary of "Anatomy and Complications Following Laparoscopic Sleeve Gastrectomy: Radiological Evaluation and Imaging Pitfalls."
BACKGROUND:
To evaluate the post-operative gastric anatomy depicted by upper gastrointestinal gastrografin swallow studies (UGI) and report radiological work-up and management of complications following laparoscopic sleeve gastrectomy (LSG).
METHODS:
The study included 85 consecutive patients who underwent LSG for the treatment of morbid obesity. In all patients, a UGI was routinely performed on POD 3 to exclude early complications. In patients with suspected complications, further radiological evaluation with computed tomography (CT) was performed. The anatomy of the gastric remnant depicted by UGI was retrospectively evaluated in all patients.
RESULTS:
The patterns of the gastric remnant identified were the tubular (65.9%), the superior pouch (25.9%), and the inferior pouch pattern (8.2%). Three patients had small superior pouches that resembled leaks, and the diagnosis was based on clinical symptoms. Post-operative complications were observed in 12.9% and included leaks (3.5%), hemorrhages (3.5%), strictures (2.3%), pulmonary embolism (1.2%), trocar site hernia (1.2%), and hematoma of the rectus abdominal muscle (1.2%). No mortality was noted.
CONCLUSIONS:
Post-operative radiological evaluation by UGI and CT is important for diagnosis and management of complications following LSG. Familiarity with the anatomy of the gastric remnant at UGI is essential for correct image interpretation.
Affiliation
Department of Radiology, University Hospital of Larissa, University of Thessalia, Larissa, Greece.
Journal Details
This article was published in the following journal.
Name: Obesity surgery
ISSN: 1708-0428
Pages:
Links
- PubMed Source: http://www.ncbi.nlm.nih.gov/pubmed/20652760
- DOI: http://dx.doi.org/10.1007/s11695-010-0236-6
Medical and Biotech [MESH] Definitions
Gastrectomy
Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed)
Intraoperative Complications
Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.
Anatomy, Cross-sectional
Descriptive anatomy based on three-dimensional imaging (IMAGING, THREE-DIMENSIONAL) of the body, organs, and structures using a series of computer multiplane sections, displayed by transverse, coronal, and sagittal analyses. It is essential to accurate interpretation by the radiologist of such techniques as ultrasonic diagnosis, MAGNETIC RESONANCE IMAGING, and computed tomography (TOMOGRAPHY, X-RAY COMPUTED). (From Lane & Sharfaei, Modern Sectional Anatomy, 1992, Preface)
Evaluation Studies As Topic
Studies determining the effectiveness or value of processes, personnel, and equipment, or the material on conducting such studies. For drugs and devices, CLINICAL TRIALS AS TOPIC; DRUG EVALUATION; and DRUG EVALUATION, PRECLINICAL are available.
Program Evaluation
Studies designed to assess the efficacy of programs. They may include the evaluation of cost-effectiveness, the extent to which objectives are met, or impact.
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