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01.04.2011 | Clinical Research | Ausgabe 4/2011

Obesity Surgery 4/2011

Anatomy and Complications Following Laparoscopic Sleeve Gastrectomy: Radiological Evaluation and Imaging Pitfalls

Zeitschrift:
Obesity Surgery > Ausgabe 4/2011
Autoren:
George Triantafyllidis, Olga Lazoura, Eleni Sioka, George Tzovaras, Afroditi Antoniou, Katerina Vassiou, Dimitris Zacharoulis
Wichtige Hinweise
No commercial interests. No financial support.

Abstract

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.

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