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Girishekar B, Rawat S, Ananthasivan R, Reddy P, Patil P, Kaushik K. Role of Imaging in Bariatric Surgery: A Review of the Various Surgical Techniques and Their Complications. JOURNAL OF GASTROINTESTINAL AND ABDOMINAL RADIOLOGY 2021. [DOI: 10.1055/s-0041-1725240] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022] Open
Abstract
AbstractAccording to the World Health Organization, obesity has reached epidemic proportions globally, with at least 2.8 million people dying each year as a result of being overweight or obese. Bariatric surgery is being increasingly used as a form of treatment, particularly in those patients where lifestyle modifications are deemed insufficient. With the role of radiologists transitioning from a medical to a surgical evaluation in obesity, it is becoming increasingly important to familiarize oneself with the various imaging techniques used in the preoperative and postsurgical evaluation in such cases. This article aims to review the various surgeries performed, their normal imaging appearance, and the various complications that could be encountered.
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Affiliation(s)
| | - Sudarshan Rawat
- Department of Radiology, Manipal Hospital, Bengaluru, Karnataka, India
| | - Rupa Ananthasivan
- Department of Radiology, Manipal Hospital, Bengaluru, Karnataka, India
| | - Pramesh Reddy
- Department of Radiology, Manipal Hospital, Bengaluru, Karnataka, India
| | - Pooja Patil
- Department of Radiology, Manipal Hospital, Bengaluru, Karnataka, India
| | - Kavya Kaushik
- Department of Radiology, Manipal Hospital, Bengaluru, Karnataka, India
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2
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A review of commonly performed bariatric surgeries: Imaging features and its complications. Clin Imaging 2020; 72:122-135. [PMID: 33232899 DOI: 10.1016/j.clinimag.2020.11.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 10/13/2020] [Accepted: 11/08/2020] [Indexed: 01/15/2023]
Abstract
Obesity is a disease that has achieved the level that can be considered an epidemic. According to the National Center for Health Statistics data, the prevalence of obesity has increased from 30.5% in 1999-2000 to 42.4% in 2017-2018. During the same period, severe obesity has increased from 4.7% to 9.2%. With the growing prevalence of obesity, related conditions such as coronary artery disease, diabetes, and strokes have also become more prevalent. In the past few years, the need for bariatric surgeries such as laparoscopic Roux-en-Y gastric bypass, sleeve gastrectomy, and laparoscopic adjustable gastric banding has increased considerably. With an increasing number of bariatric surgeries, multiple postoperative complications have become common. In this review, we have attempted to describe normal postsurgical anatomical findings after bariatric surgeries and pictorial review of a few common postoperative complications.
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Karampinis I, Lion E, Grilli M, Hetjens S, Weiss C, Vassilev G, Seyfried S, Otto M. Trocar Site Hernias in Bariatric Surgery-an Underestimated Issue: a Qualitative Systematic Review and Meta-Analysis. Obes Surg 2020; 29:1049-1057. [PMID: 30659465 DOI: 10.1007/s11695-018-03687-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
The reported incidence of trocar site hernias in bariatric surgery ranges between 0.5 and 3%. The best available evidence derives from retrospective studies analysing prospective databases, thus including only patients who presented with symptoms or received surgical treatment due to trocar site hernias after a laparoscopic bariatric procedure. A systematic literature research was conducted up until September 2017. Search strategies included proper combinations of the MeSH terms 'laparoscopy' and 'bariatric surgery', 'trocar/port' and 'hernia'. Searches were not limited by publication type or language. The review was registered in PROSPERO (ID 85102) and performed according to the PRISMA guidelines. Sixty-eight publications were included. Pooled hernia incidence was 3.22 (range 0-39.3%). Thirteen trials reported systematic closure of the fascia; 12 trials reported no closure. Data availability did not allow for pooling to calculate relative risk. Higher BMI and specific hernia examination using imaging modalities were associated with a significantly higher incidence of trocar site hernias. Studies dedicated to detection of TsH reported a pooled incidence of 24.5%. Trocar site hernias are an underestimated complication of minimally invasive multiportal bariatric surgery. While high-quality trials are not available allowing for a precise calculation of the incidence, existing data are indicative of very high incidence rates. Risk factors for developing a trocar site hernia in bariatric surgery have not yet been systematically analysed. Prospective studies in this field are necessary.
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Affiliation(s)
| | - Eliette Lion
- Department of Surgery, Heidelberg University, Mannheim, Germany
| | - Maurizio Grilli
- Department of Library and Information Sciences, Heidelberg University, Mannheim, Germany
| | - Svetlana Hetjens
- Institute of Medical Statistic and Biomathematics, Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christel Weiss
- Institute of Medical Statistic and Biomathematics, Department of Surgery, Universitätsmedizin Mannheim, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Georgi Vassilev
- Department of Surgery, Heidelberg University, Mannheim, Germany
| | | | - Mirko Otto
- Department of Surgery, Heidelberg University, Mannheim, Germany.
- Department of Surgery, Mannheim University Medical Centre, University of Heidelberg, Theodor-Kutzer-Ufer 1-3, 68167, Mannheim, Germany.
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Clayton RD, Carucci LR. Imaging following bariatric surgery: roux-en-Y gastric bypass, laparoscopic adjustable gastric banding and sleeve gastrectomy. Br J Radiol 2018; 91:20180031. [PMID: 29869916 PMCID: PMC6223156 DOI: 10.1259/bjr.20180031] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2017] [Revised: 05/29/2018] [Accepted: 05/30/2018] [Indexed: 12/13/2022] Open
Abstract
Morbid obesity is an increasing health problem, and bariatric surgery is a popular treatment option. Radiologists must be familiar with performing and interpreting studies in this patient population. The typical post-operative findings of the Roux-en-Y gastric bypass (RYGB), laparoscopic adjustable gastric banding (LAGB) and sleeve gastrectomy (SG) procedures on upper gastrointestinal (UGI) series and computerized tomography (CT) are presented. An overview of the potential complications is provided in addition to a description of potential pitfalls in interpreting these studies.
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Affiliation(s)
- Ryan D Clayton
- Department of Radiology, VCU Health System, Richmond, VA, USA
| | - Laura R Carucci
- Department of Radiology, VCU Health System, Richmond, VA, USA
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Scharitzer M, Pokieser P. Radiology of the Lower Esophageal Sphincter and Stomach in Patients with Swallowing Disorders. Dysphagia 2017. [DOI: 10.1007/174_2017_115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
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Owers CE, Barkley SM, Ackroyd R. Gastric band port site fixation: which method is best? J Obes 2015; 2015:701689. [PMID: 25694826 PMCID: PMC4324985 DOI: 10.1155/2015/701689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Accepted: 01/07/2015] [Indexed: 11/17/2022] Open
Abstract
Laparoscopic adjustable gastric banding is a popular and successful bariatric surgical technique. Although short-term complications are few in number, long-term complications are more common. One such complication is flippage of the gastric band port. This study compares three popular methods of port fixation and demonstrates that fixation with nonabsorbable mesh helps to prevent port flippage when compared to other techniques, reducing the need for repositioning operations.
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Affiliation(s)
- Corinne E. Owers
- Department of Upper GI and Bariatric Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield S5 7AU, UK
- *Corinne E. Owers:
| | - Sarah M. Barkley
- Department of Upper GI and Bariatric Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield S5 7AU, UK
| | - Roger Ackroyd
- Department of Upper GI and Bariatric Surgery, Sheffield Teaching Hospitals NHS Foundation Trust, Herries Road, Sheffield S5 7AU, UK
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Fried M, Yumuk V, Oppert JM, Scopinaro N, Torres A, Weiner R, Yashkov Y, Frühbeck G. Interdisciplinary European guidelines on metabolic and bariatric surgery. Obes Surg 2014; 24:42-55. [PMID: 24081459 DOI: 10.1007/s11695-013-1079-8] [Citation(s) in RCA: 395] [Impact Index Per Article: 39.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
In 2012, an expert panel composed of presidents of each of the societies, the European Chapter of the International Federation for the Surgery of Obesity (IFSO-EC), and of the European Association for the Study of Obesity (EASO), as well as of the chair of EASO Obesity Management Task Force (EASO OMTF) and other key representatives from IFSO-EC and EASO, devoted the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery in advance of the 2013 European Congress on Obesity held in Liverpool. This meeting was prompted by the extraordinary advancement made in the field of metabolic and bariatric surgery during the past decade. It was agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced by focusing in particular on the evidence gathered in relation to the effects on diabetes and the changes in the recommendations of patient eligibility criteria. The expert panel allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.
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Affiliation(s)
- M Fried
- Center for Treatment of Obesity and Metabolic Disorders, OB Klinika, Prague, Czech Republic,
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JOURNAL CLUB: Gastric Band Slippage: A Case-Controlled Study Comparing New and Old Radiographic Signs of This Important Surgical Complication. AJR Am J Roentgenol 2014; 203:10-6. [DOI: 10.2214/ajr.13.11650] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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9
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Levine MS, Carucci LR. Imaging of bariatric surgery: normal anatomy and postoperative complications. Radiology 2014; 270:327-41. [PMID: 24471382 DOI: 10.1148/radiol.13122520] [Citation(s) in RCA: 72] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Obesity is a disease that has reached epidemic proportions in the United States and around the world. During the past 2 decades, bariatric surgery has become an increasingly popular form of treatment for morbid obesity. The most common bariatric procedures performed include laparoscopic Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and laparoscopic sleeve gastrectomy. Fluoroscopic upper gastrointestinal examinations and abdominal computed tomography (CT) are the major imaging tests used to evaluate patients after these various forms of bariatric surgery. The purpose of this article is to present the surgical anatomy and normal imaging findings and postoperative complications for these bariatric procedures at fluoroscopic examinations and CT. Complications after Roux-en-Y gastric bypass include anastomotic leaks and strictures, marginal ulcers, jejunal ischemia, small bowel obstruction, internal hernias, intussusception, and recurrent weight gain. Complications after laparoscopic adjustable gastric banding include stomal stenosis, malpositioned bands, pouch dilation, band slippage, perforation, gastric volvulus, intraluminal band erosion, and port- and band-related problems. Finally, complications after sleeve gastrectomy include postoperative leaks and strictures, gastric dilation, and gastroesophageal reflux. The imaging features of these various complications of bariatric surgery are discussed and illustrated.
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Affiliation(s)
- Marc S Levine
- From the Department of Radiology, Hospital of the University of Pennsylvania, 3400 Spruce St, Philadelphia, PA 19104 (M.S.L.); and Department of Radiology, VCU Medical Center, Richmond, VA (L.R.C.)
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Abstract
PURPOSE Pouch dilatation and band slippage are the most common long-term complications after laparoscopic adjustable gastric banding (LAGB). The aim of the study is to present our experience of diagnosis and management of these complications. MATERIALS AND METHODS The pars flaccida technique with anterior fixation of the fundus was routinely used. All band adjustments were performed under fluoroscopy. We analyzed the incidence, clinico-radiologic features, management, and revisional surgeries for treatment of these complications. We further presented the outcome of gastric plication techniques as a measure for prevention of these complications. RESULTS From March 2009 to March 2012, we performed LAGB on 126 morbidly obese patients. Among them, 14 patients (11.1%) were diagnosed as having these complications. Four patients (3.2%) had concentric pouch dilatations, which were corrected by band adjustment. Ten (7.9%) had eccentric pouch with band slippage. Among the ten patients, there were three cases of posterior slippage, which were corrected by reoperation, and seven cases of eccentric pouch dilatation with anterior slippage. Three were early anterior slippage, which was managed conservatively. Two were acute anterior slippage, one of whom underwent a revision. There were two cases of chronic anterior slippage, one of whom underwent a revision. The 27 patients who underwent gastric plication did not present with eccentric pouch with band slippage during the follow-up period. CONCLUSION The incidence of pouch dilatation with/without band slippage was 11.1%. Management should be individualized according to clinico-radiologic patterns. Gastric plication below the band might prevent these complications.
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Affiliation(s)
- Woon Ki Lee
- Department of Surgery, Gil Medical Center, Gachon University of Medicine, 21 Namdong-daero 774beon-gil, Namdong-gu, Incheon 405-760, Korea.
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Ni Mhuircheartaigh J, Abedin S, Bennett AE, Tyagi G. Imaging Features of Bariatric Surgery and Its Complications. Semin Ultrasound CT MR 2013; 34:311-24. [DOI: 10.1053/j.sult.2013.04.005] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
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Fried M, Yumuk V, Oppert JM, Scopinaro N, Torres AJ, Weiner R, Yashkov Y, Frühbeck G. Interdisciplinary European Guidelines on metabolic and bariatric surgery. Obes Facts 2013; 6:449-68. [PMID: 24135948 PMCID: PMC5644681 DOI: 10.1159/000355480] [Citation(s) in RCA: 189] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2013] [Accepted: 09/09/2013] [Indexed: 12/12/2022] Open
Abstract
In 2012, an outstanding expert panel derived from IFSO-EC (International Federation for the Surgery of Obesity-European Chapter) and EASO (European Association for the Study of Obesity), composed by key representatives of both Societies including past and present presidents together with EASO's OMTF (Obesity Management Task Force) chair, agreed to devote the joint Medico-Surgical Workshop of both institutions to the topic of metabolic surgery as a pre-satellite of the 2013 European Congress on Obesity (ECO) to be held in Liverpool given the extraordinarily advancement made specifically in this field during the past years. It was further agreed to revise and update the 2008 Interdisciplinary European Guidelines on Surgery of Severe Obesity produced in cooperation of both Societies by focusing in particular on the evidence gathered in relation to the effects on diabetes during this lustrum and the subsequent changes that have taken place in patient eligibility criteria. The expert panel composition allowed the coverage of key disciplines in the comprehensive management of obesity and obesity-associated diseases, aimed specifically at updating the clinical guidelines to reflect current knowledge, expertise and evidence-based data on metabolic and bariatric surgery.
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Affiliation(s)
- Martin Fried
- OB Klinika, Centre for Treatment of Obesity and Metabolic Disorders, 1st Faculty of Medicine, Charles University, Prague, Czech Republic, Istanbul, Turkey
| | - Volkan Yumuk
- Division of Endocrinology, Metabolism and Diabetes, Istanbul University Cerrahpasa Medical Faculty, Istanbul, Turkey
| | - Jean-Michel Oppert
- Department of Nutrition, Heart and Metabolism Division, Pitie Salpetriere University Hospital (AP-HP) University Pierre et Marie Curie-Paris 6, Institute of Cardiometabolism and Nutrition (ICAN) Paris, France
| | | | - Antonio J. Torres
- Department of Surgery Complutense University of Madrid, Hospital Clinico ‘San Carlos’, Madrid, Spain
| | - Rudolf Weiner
- Sachsenhausen Hospital and Centre for Minimally Invasive Surgery, Johan Wolfgang Goethe University, Frankfurt/M., Germany, Spain
| | - Yuri Yashkov
- Obesity Surgery Service, Centre of Endosurgery and Lithotripsy Moscow, Russia, Spain
| | - Gema Frühbeck
- Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, CIBERobn, Instituto de Salud Carlos III, Pamplona, Spain
- *Gema Frühbeck, R Nutr MD PhD, Department of Endocrinology and Nutrition, Clínica Universidad de Navarra, CIBERobn, Instituto de Salud Carlos III, Avda. Pio XII, 36, 31008 Pamplona (Spain),
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13
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Flowers D, Pearce O, Somers S, Higginson A. Gastric bands: what the general radiologist should know. Clin Radiol 2012; 68:488-99. [PMID: 23031824 DOI: 10.1016/j.crad.2012.08.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2012] [Revised: 08/09/2012] [Accepted: 08/15/2012] [Indexed: 11/30/2022]
Abstract
Obesity in the UK is increasing, it is estimated that in England 24% of men and 25% of women are obese.(1,2) In recent years bariatric surgery has become increasingly common and is effective in producing long-term weight loss.(4,5) The most popular form of bariatric surgery in Europe is laparoscopic adjustable gastric banding (LAGB).(6) Radiologists play a key role assessing the normal function of bands, adjusting their filling under fluoroscopic guidance, and in recognizing and managing complications. This review will describe the general principles of LAGB; how they are assessed, how to recognize the most common complications, an overview of the appearances of the bands used in the UK, and novel developments in their use and design.
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Affiliation(s)
- D Flowers
- Department of Radiology, Queen Alexandra Hospital, Portsmouth, UK.
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Averill LW, Stevenson KL, Kecskemethy HH, Reichard K, Datto GA, Grissom L. Pre- and postoperative imaging of adolescents undergoing laparoscopic adjustable gastric banding surgery. Pediatr Radiol 2012; 42:834-41. [PMID: 22419051 DOI: 10.1007/s00247-012-2363-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2011] [Revised: 12/21/2011] [Accepted: 01/13/2012] [Indexed: 11/28/2022]
Abstract
BACKGROUND As childhood obesity rates rise, laparoscopic adjustable gastric banding (LAGB) is being investigated as a bariatric surgical option in adolescents. OBJECTIVE To examine pre- and postoperative imaging in adolescents undergoing LAGB, describe the most common abnormal preoperative imaging findings, and illustrate the typical appearance and variants on postoperative upper-gastrointestinal (UGI) examinations. MATERIALS AND METHODS A retrospective chart review was performed of all adolescents from 2008 to 2010 undergoing LAGB at a single tertiary-care pediatric hospital. The picture archiving and communication system was queried for all imaging obtained before and after surgery. Postoperative UGI studies were analyzed for common patterns. RESULTS Twenty-seven obese adolescents who underwent LAGB were identified. Twenty-five had preoperative imaging, most commonly a UGI study (81.5%). Eight UGI studies were abnormal but did not impact surgery. Preoperative chest and neck radiographs were also common. Intraoperative imaging was rare. Seventy-three postoperative UGI studies were performed on 22 children (range, 2-12 studies). A common postoperative imaging pattern was observed in 19/22 (86%) children. No complications were observed. CONCLUSION The most common pre- and postoperative imaging studies in adolescents undergoing LAGB are UGI studies. Pediatric radiologists should be familiar with the imaging of LAGB as this procedure becomes increasingly common.
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Affiliation(s)
- Lauren W Averill
- Department of Medical Imaging, Nemours/Alfred I. duPont Hospital for Children, Wilmington, DE 19803, USA.
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Sonavane SK, Menias CO, Kantawala KP, Shanbhogue AK, Prasad SR, Eagon JC, Sandrasegaran K. Laparoscopic Adjustable Gastric Banding: What Radiologists Need to Know. Radiographics 2012; 32:1161-78. [DOI: 10.1148/rg.324115177] [Citation(s) in RCA: 55] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Glenn JA, Ortega G, Gonzalez DO, Reed JA, Turner PL, Tran DD, McKenna S, Bauer CC, Fullum TM. Gastric prolapse with pseudocysts following laparoscopic adjustable gastric banding. JSLS 2012; 15:542-5. [PMID: 22643513 PMCID: PMC3340967 DOI: 10.4293/108680811x13176785204436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Nonpancreatic pseudocysts may be associated with gastric prolapse in patients who have undergone laparoscopic adjustable gastric banding. Introduction: Laparoscopic adjustable gastric banding (LAGB) is a reversible method of surgical gastric restriction. Following LAGB, the adverse event most commonly necessitating subsequent reoperation is prolapse of the gastric corpus or fundus above the band. A review of the medical literature reveals no reports of nonpancreatic pseudocysts being associated with this adverse event. Nonpancreatic pseudocysts, encountered during revisional bariatric surgery should be considered a cause of irreducible gastric prolapse. Case Report: We report the case of a 41-year-old Caucasian female who underwent laparoscopic surgery to revise an adjustable gastric band and to repair an anterior gastric prolapse. Intraoperatively, 2 pseudocysts were found on the gastric fundus above the band in association with the gastric prolapse. The pseudocysts were resected, the gastric prolapse was reduced, and the band was left in place. The patient recovered uneventfully. Conclusion: Nonpancreatic pseudocysts may be associated with gastric prolapse in patients who have undergone LAGB. These pseudocysts can often be excised laparoscopically without violating the gastric lumen. This atypical presentation of gastric prolapse may pose a diagnostic and therapeutic challenge as these patients may present to an outpatient clinic or emergency room with nonspecific symptoms.
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Affiliation(s)
- Jason A Glenn
- Howard University College of Medicine, Washington, DC, USA
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Intraluminal erosion and retrograde migration of laparoscopic gastric band with high-grade obstruction at gastroesophageal junction. Surg Obes Relat Dis 2012; 8:e14-6. [DOI: 10.1016/j.soard.2010.03.290] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2010] [Revised: 03/18/2010] [Accepted: 03/18/2010] [Indexed: 11/18/2022]
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18
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Case of the month. Adjustable gastric band erosion. JAAPA 2011; 24:82. [PMID: 22010573 DOI: 10.1097/01720610-201110000-00019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Quigley S, Colledge J, Mukherjee S, Patel K. Bariatric surgery: A review of normal postoperative anatomy and complications. Clin Radiol 2011; 66:903-14. [DOI: 10.1016/j.crad.2011.04.017] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 04/05/2011] [Accepted: 04/26/2011] [Indexed: 11/17/2022]
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Abstract
Because bariatric surgery is becoming increasingly common, gastroenterologists need to be familiar with the surgical and endoscopic anatomy of the operations in use today. This review focuses on the 4 most commonly performed bariatric operations in the United States: Roux-en-Y gastric bypass, adjustable gastric band, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch. The anatomy and mechanism of action of each procedure is discussed and illustrated. Emphasis is placed on the endoscopic anatomy, with review of the commonly encountered complications. Emerging techniques and devices are reviewed.
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Affiliation(s)
- Daniel M Herron
- Department of Surgery, Mount Sinai School of Medicine, 1 Gustave L. Levy Place, #1259, New York, NY 10029, USA.
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Mar N, Graham RE. Lung abscess, esophageal dilation, and bulimia--six degrees of separation from adjustable gastric banding. Surg Obes Relat Dis 2011; 8:e11-3. [PMID: 21388890 DOI: 10.1016/j.soard.2011.01.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2011] [Revised: 01/13/2011] [Accepted: 01/14/2011] [Indexed: 11/25/2022]
Affiliation(s)
- Nataliya Mar
- Department of Internal Medicine, Lenox Hill Hospital, New York, New York, USA.
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22
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Carucci LR. Role of imaging in bariatric procedures: Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/iim.10.67] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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The surgical management of obesity with emphasis on the role of post operative imaging. Biomed Imaging Interv J 2011; 7:e8. [PMID: 21655117 PMCID: PMC3107690 DOI: 10.2349/biij.7.1.e8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2010] [Revised: 10/14/2010] [Accepted: 11/06/2010] [Indexed: 12/21/2022] Open
Abstract
The role of surgery in the morbidly obese is becoming more prominent. There are a variety of surgical approaches which can be used and radiology plays a crucial role in post operative follow up, particularly in the management of complications. Many general radiologists remain unfamiliar with both the normal and abnormal appearances after bariatric surgery and this pictorial review aims to bridge this gap.
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The “O” Sign, a Simple and Helpful Tool in the Diagnosis of Laparoscopic Adjustable Gastric Band Slippage. AJR Am J Roentgenol 2010; 195:137-41. [DOI: 10.2214/ajr.09.3933] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Routine postoperative upper gastrointestinal fluoroscopy is unnecessary after laparoscopic adjustable gastric band placement. Surg Endosc 2010; 24:2188-91. [PMID: 20349088 DOI: 10.1007/s00464-010-0924-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2009] [Accepted: 01/10/2010] [Indexed: 01/30/2023]
Abstract
BACKGROUND Laparoscopic adjustable gastric banding (LAGB) has become an accepted procedure for weight loss surgery, particularly due to fewer early complications and decreased mortality in comparison to other bariatric procedures. Many centers use postoperative upper gastrointestinal fluoroscopy (UGI) to ensure stomal patency and gastric integrity at the banding site. However, UGI increases cost and may increase length of stay due to availability. The purpose of this study is to determine whether routine UGI after LAGB is necessary for detection of early complications. METHODS A prospective database of 200 LAGBs performed by a single surgeon over 3 years was reviewed retrospectively. All patients underwent UGI 2-24 h after surgery. RESULTS Mean age was 43, mean BMI was 45, and mean operative time was 44 min. Forty-four percent of patients stayed overnight. All postoperative UGI results were normal. Six percent underwent intraoperative instillation of methylene blue due to procedural difficulty with no leaks identified. These patients on average were 5 years older ( p< 0.01) and had an operative time 23 min longer (p < 0.01). Differences in gender and BMI were not statistically significant. One patient (0.5%), who had a normal methylene blue test and normal UGI, returned within 2 days with a gastric perforation requiring band explant and gastric repair. CONCLUSIONS We conclude that routine UGI after LAGB is not necessary based on a 0% stomal obstruction rate and detection of not a single gastric leak. Elimination of routine postoperative UGI will decrease cost and length of hospital stay. We suggest a selective approach for those patients at increased risk of early postoperative complications, including those having intraoperative methylene blue instillation, increased length of operation, and increased age.
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Utility of routine barium studies after adjustments of laparoscopically inserted gastric bands. AJR Am J Roentgenol 2010; 194:129-35. [PMID: 20028914 DOI: 10.2214/ajr.09.2669] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE The purposes of this study were to assess the utility of barium studies after adjustments of laparoscopically inserted gastric bands and to identify a threshold stomal diameter for predicting which bands should be loosened because of excessive tightening. MATERIALS AND METHODS A total of 246 patients with laparoscopically inserted adjustable gastric bands underwent 668 routine band adjustments and barium studies after each adjustment. Forty-one barium studies of 30 patients with tight bands necessitating readjustment were compared with barium studies of 41 patients acting as controls. Barium studies of nine patients with obstructive symptoms before adjustment were reviewed to correlate stomal diameter with symptoms. The data were analyzed for a threshold stomal diameter below which obstructive symptoms were likely to develop. RESULTS Mean stomal diameters were 2.9 mm for the group with tight bands after routine adjustment, 9.5 mm for the control group, and 5.1 mm for the group with obstructive symptoms. Thirty-nine of the 41 studies of tight bands after routine adjustment showed stomal diameters less than 6 mm. Seven of nine patients with obstructive symptoms and none of the 41 control patients had stomal diameters measuring less than 6 mm. Conversely, 40 of 41 control patients and two of nine patients with obstructive symptoms had stomal diameters greater than 6 mm. In none of the 41 cases in which the band was tight after routine adjustment was the stomal diameter greater than 6 mm. Thus, 6 mm was the threshold stomal diameter below which bands should be loosened. CONCLUSION A stomal diameter of less than 6 mm after routine adjustment of a laparoscopically inserted gastric band can cause obstructive symptoms, so the band should be loosened in these patients. In contrast, a stomal diameter greater than 7 mm is unlikely to cause obstructive symptoms, so band loosening usually is not required.
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Carucci LR, Turner MA. Imaging after bariatric surgery for morbid obesity: Roux-en-Y gastric bypass and laparoscopic adjustable gastric banding. Semin Roentgenol 2009; 44:283-96. [PMID: 19715793 DOI: 10.1053/j.ro.2009.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Laura R Carucci
- Department of Radiology, Abdominal Imaging Section, Virginia Commonwealth University Medical Center, Richmond, VA 23298-0615, USA.
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Varghese JC, Roy-Choudhury SH. Radiological imaging of the GI tract after bariatric surgery. Gastrointest Endosc 2009; 70:1176-81. [PMID: 19846080 DOI: 10.1016/j.gie.2009.06.025] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2009] [Accepted: 06/22/2009] [Indexed: 02/08/2023]
Abstract
BACKGROUND Obesity is becoming epidemic in proportion and is leading to considerable morbidity and mortality in the community. Bariatric surgery offers one tested solution to sustained weight loss and comorbidity reduction. However, it is associated with a significant number of complications. OBJECTIVE The objective of this article is to review the utility of radiological techniques in the diagnosis of surgical complications after bariatric surgery. DESIGN Literature-based review and pictorial illustration in the use of imaging techniques in the diagnosis of complications after bariatric surgery. CONCLUSIONS Radiology plays a critical role in the diagnosis of complications after bariatric surgery. Upper GI contrast study and CT are the most commonly used imaging modalities in this regard. They are complementary in their diagnostic abilities and should be used in concert for the complete evaluation of symptomatic patients. All other radiological imaging modalities are also used in the diagnosis of complications after bariatric surgery, but much less commonly.
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Affiliation(s)
- Jose C Varghese
- Department of Radiology, Quincy Medical Center, Quincy, MA 02169, USA
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Kroh M, Brethauer S, Duelley N, Rogula T, Schauer P, Chand B. Surgeon-performed fluoroscopy conducted simultaneously during all laparoscopic adjustable gastric band adjustments results in significant alterations in clinical decisions. Obes Surg 2009; 20:188-92. [PMID: 19763706 DOI: 10.1007/s11695-009-9972-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2009] [Accepted: 09/01/2009] [Indexed: 11/26/2022]
Abstract
BACKGROUND Little data exists regarding filling regimens for laparoscopic adjustable gastric bands (LAGB). In addition to patient symptoms and weight changes, we have instituted surgeon-performed, real-time fluoroscopic evaluation in our clinical decision making during all band adjustments. OBJECTIVE Our hypothesis is that surgeon-performed, real-time contrast fluoroscopy conducted routinely during all LAGB adjustment results in significant deviations in clinical care. SETTING The study is set at the Academic Referral Center, United States METHODS Fifty-two consecutive patients who underwent LAGB and presented for adjustment were given a questionnaire evaluating obstructive symptoms. The patient's weight loss history was also reviewed. Each patient underwent real-time fluoroscopy performed by the surgeon during adjustment. Data were recorded and compared to final decision to fill, make no adjustment, or remove fluid. RESULTS Patients were, on average, at post-operative visit 5. Sixty-three percent of patients received a fill, 31% had no change, and 6% had fluid removed. On the questionnaire, 15% of patients noted reflux, 10% had dysphagia, and 8% had regurgitation. Eighty percent of patients requested a fill. Thirty-one percent had an abnormality noted on fluoroscopy. Fifteen percent of patients demonstrated esophageal dilation, 15% had a delay of greater than 5 s, 19% had reflux of contrast. Three patients had band displacements on imaging. Additionally, six patients (12%) were not filled based on fluoroscopic findings alone, not predicted by either the survey or historical weight loss. CONCLUSION Surgeon-performed, real-time, fluoroscopy during LAGB adjustment results in significant changes in clinical care that are not predicted by history and weight loss alone. Routine fluoroscopic imaging altered the course of management in 12% of patients and identified three asymptomatic displaced bands.
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Affiliation(s)
- Matthew Kroh
- Cleveland Clinic Bariatric and Metabolic Institute, Cleveland, OH, USA.
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Abstract
Surgery for morbid obesity has become commonplace in the United States. Any radiologist who reads abdominal films, body CT, or does gastrointestinal fluoroscopy should be familiar with the surgical procedures and their imaging. Included in this update will be discussions of the vertical banded gastroplasty, Roux-en-Y gastric bypass, laparoscopic adjustable gastric banding, and biliopancreatic diversion with duodenal switch.
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Ridereau-Zins C, Lebigot J, Moubarak E, Hamy A, Azoulay R, Aubé C. Imagerie post-opératoire du cardia et de l’estomac. ACTA ACUST UNITED AC 2009; 90:937-53. [DOI: 10.1016/s0221-0363(09)73233-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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Radiological features of complications of laparoscopic adjustable gastric banding. Radiol Med 2009; 114:802-10. [DOI: 10.1007/s11547-009-0389-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2008] [Accepted: 10/24/2008] [Indexed: 10/20/2022]
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Toouli J, Kow L, Ramos AC, Aigner F, Pattyn P, Galvão-Neto MP, Miller KA, Romano S, Gutierrez M, Jokinen J. International multicenter study of safety and effectiveness of Swedish Adjustable Gastric Band in 1-, 3-, and 5-year follow-up cohorts. Surg Obes Relat Dis 2009; 5:598-609. [PMID: 19656740 DOI: 10.1016/j.soard.2009.04.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2008] [Revised: 03/11/2009] [Accepted: 04/22/2009] [Indexed: 10/20/2022]
Abstract
BACKGROUND No long-term, international, multicenter studies of the effectiveness and safety of the SAGB in morbid obesity have been previously published. The objective of this study was to assess the effectiveness and safety of the Swedish Adjustable Gastric Band (SAGB) at 6 bariatric centers in Australia, Europe, and Brazil, with < or =5 years of follow-up; the effect on patient covariates; and changes in co-morbidity. METHODS A 2-phase study design was used, involving both retrospective and prospective data. SAGB was implanted by way of the pars flaccida 1, 3, and 5 years previously. The retrospective phase entailed a review of the records. The prospective phase included a subset of eligible patients who agreed to undergo additional clinical assessments. The percentage of excess weight loss (%EWL), patient level predictors, change in co-morbidities, and complications were analyzed. RESULTS A total of 481 patients in 3 mutually exclusive follow-up cohorts (1 yr, n = 200; 3 yr, n = 184; 5 yr, n = 97) participated in the present study. Of these 481 patients, 339 (1 yr, n = 139; 3 yr, n = 131; 5 yr, n = 69) underwent prospective evaluations. The mean %EWL was 43.5% + or - 21.8%, 57.7% + or - 25.9%, and 49.8% + or - 27.6% and the mean change in body mass index was -7.64, -10.75, and -9.52 in the 1-, 3-, and 5-year cohorts, respectively (P <.001). Gender and age did not predict the %EWL; however, a greater preoperative body mass index was inversely related to the %EWL. Longer postimplantation times were associated with greater improvement in co-morbidities and with greater frequencies of reoperation. Fewer than 15% of the patients in the 5-year cohort had undergone band removal and 10% required band revisions. No fatal or life-threatening complications occurred. CONCLUSION SAGB is safe and effective in inducing weight loss and improvement of co-morbidities in morbidly obese patients at international bariatric centers at 1, 3, and 5 years postoperatively.
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Affiliation(s)
- James Toouli
- Department of Surgery, Flinders University of South Australia, Flinders Medical Centre, Bedford Park, South Australia 5042, Australia
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Adjustable laparoscopic gastric banding: demonstrated on multidetector computed tomography with multiplanar reformation and 3-dimensional imaging. J Comput Assist Tomogr 2009; 33:288-90. [PMID: 19346861 DOI: 10.1097/rct.0b013e31816932ee] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Laparoscopic adjustable gastric banding (LAGB) is a widely performed surgical procedure for morbid obesity in Europe and Australia. An upper gastrointestinal examination is usually used to assess for band placement and possible complications. Computed tomography (CT) is not used routinely but may be beneficial to evaluate LAGB and possible complications. Also, LAGB may be incidentally demonstrated on CT. We report 2 patients with LAGB that was well demonstrated on multidetector CT with multiplanar reformation and 3-dimensional imaging.
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Werquin C, Caudron J, Mezghani J, Leblanc-Louvry I, Scotté M, Dacher JN, Savoye-Collet C. [Early imaging features after sleeve gastrectomy]. ACTA ACUST UNITED AC 2009; 89:1721-8. [PMID: 19106828 DOI: 10.1016/s0221-0363(08)74476-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
PURPOSE Sleeve gastrectomy is a new bariatric surgical procedure with promising early results and low morbidity and mortality. We have evaluated the early imaging findings and value of upper GI study (UGI) and CT. PATIENTS AND METHODS Twenty five patients (mean age=38.9 years, mean BMI=51.5 kg/m2) following sleeve gastrectomy for morbid obesity underwent UGI at day 1. CT was immediately performed in patients with suspected leak or as a follow-up examinations in patients with suspected complication. The different imaging features observed were recorded. RESULTS UGI demonstrated 13 normal examinations (52%), an abnormal appearance in 11 cases (44%) with opacification of a lateral pouch, and one complication (leak confirmed on CT). Two patients underweent CT (day 3 and day 15) for suspected complication, with demonstration of leak in both cases. CONCLUSION An abnormal appearance after sleeve gastrectomy is frequently observed on UGI. Routine UGI at day 1 is useful to detect large leaks. CT with oral contrast should be performed in all patients with imaging or clinical suspicion of leak.
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Affiliation(s)
- C Werquin
- Département d'Imagerie Médicale, CHU Charles Nicolle, 1, rue de Germont, 76031 Rouen Cedex, France
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Gupta D, Silberstein M, Kurian MS. Clinical and radiologic findings of massive gastric prolapse after laparoscopic adjustable gastric banding. Surg Obes Relat Dis 2009; 5:381-2. [PMID: 19136313 DOI: 10.1016/j.soard.2008.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2008] [Accepted: 09/22/2008] [Indexed: 10/21/2022]
Affiliation(s)
- Deepali Gupta
- New York University School of Medicine, New York, New York, USA
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Prosch H, Tscherney R, Kriwanek S, Tscholakoff D. Radiographical imaging of the normal anatomy and complications after gastric banding. Br J Radiol 2008; 81:753-7. [PMID: 18508872 DOI: 10.1259/bjr/95353541] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Laparoscopic adjustable gastric banding is a surgical procedure that is increasingly being performed for the treatment of morbid obesity. As with any intervention, gastric banding is not free from complications. Complications after gastric banding can be divided into early and late complications. Early complications include band malposition and perforation of the stomach. Late complications comprise pouch dilatation, intraluminal band penetration and oesophageal dilatation. Understanding the principles of the intervention is essential for both the interpretation of the resulting radiographical findings and the diagnosis of potential complications. We report on the normal anatomy and the most frequent complications seen after gastric banding.
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Affiliation(s)
- H Prosch
- Department of Radiology, Rudolfstiftung Hospital, Juchgasse 25, 1030 Vienna, Austria
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Inadequate weight loss vs secondary weight regain: laparoscopic conversion from gastric banding to Roux-en-Y gastric bypass. Obes Surg 2008; 18:1381-6. [PMID: 18438619 DOI: 10.1007/s11695-008-9479-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2008] [Accepted: 02/25/2008] [Indexed: 01/14/2023]
Abstract
BACKGROUND Beside complications like band migration, pouch-enlargement, esophageal dilation, or port-site infections, laparoscopic adjustable gastric banding (LAGB) has shown poor long-term outcome in a growing number of patients, due to primary inadequate weight loss or secondary weight regain. The aim of this study was to assess the safety and efficacy of laparoscopic conversion to Roux-en-Y gastric bypass (RYGBP) in these two indications. METHODS A total of 25 patients, who underwent laparoscopic conversion to RYGBP due to inadequate weight loss (n = 10) or uncontrollable weight regain (n = 15) following LAGB, were included to this prospective study analyzing weight loss and postoperative complications. RESULTS All procedures were completed laparoscopically within a mean duration of 219 +/- 52 (135-375) min. Mean body weight was reduced from 131 +/- 22 kg (range 95-194) at time of the RYGBP to 113 +/- 25, 107 +/- 22, and 100 +/- 21 kg at 3, 6, and 12 months, respectively, which results in excess weight losses (EWL) of 28.3 +/- 9.9%, 40.5 +/- 12.3%, and 50.8 +/- 15.2%. No statistically significant differences were found comparing weight loss within these two groups. CONCLUSION RYGBP was able to achieve EWLs of 37.6 +/- 16.1%, 48.5 +/- 15.1%, and 56.9 +/- 15.0% at 3, 6, and 12 months following conversion, respectively, based on the body weight at LAGB.
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40
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Leukocyte Scintigraphy SPECT/CT Software Fusion Diagnosis of Infected Gastric Band. Obes Surg 2008; 18:902-4. [DOI: 10.1007/s11695-008-9451-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2007] [Accepted: 01/23/2008] [Indexed: 10/22/2022]
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Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, Greve JWM, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K. Interdisciplinary European guidelines on surgery of severe obesity. Obes Facts 2008; 1:52-9. [PMID: 20054163 PMCID: PMC6444702 DOI: 10.1159/000113937] [Citation(s) in RCA: 104] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
In 2005, for the first time in European history, an extraordinary expert panel named BSCG (Bariatric Scientific Collaborative Group), was appointed through joint effort of the major European scientific societies which are active in the field of obesity management. Societies that constituted this panel were: IFSO - International Federation for the Surgery of Obesity, IFSO-EC - International Federation for the Surgery of Obesity - European Chapter, EASO - European Association for Study of Obesity, ECOG - European Childhood Obesity Group, together with the IOTF (International Obesity Task Force) which was represented during the completion process by its representative. The BSCG was composed not only of the top officers representing the respective scientific societies (four acting presidents, two past presidents, one honorary president, two executive directors), but was balanced with the presence of many other key opinion leaders in the field of obesity. The BSCG composition allowed the coverage of key disciplines in comprehensive obesity management, as well as reflecting European geographical and ethnic diversity. This joint BSCG expert panel convened several meetings which were entirely focused on guidelines creation, during the past 2 years. There was a specific effort to develop clinical guidelines, which will reflect current knowledge, expertise and evidence based data on morbid obesity treatment.
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Affiliation(s)
- Martin Fried
- Clinical Center for Minimally Invasive and Bariatric Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic.
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Adjustment of laparoscopic banding device with the aid of an angiographic compression device. AJR Am J Roentgenol 2008; 190:W128-9. [PMID: 18212195 DOI: 10.2214/ajr.07.2528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Adjustable laparoscopic gastric banding has been used as a surgical means of weight reduction. Percutaneous access of the port for adjustment can be difficult even if imaging guidance is used. We present a novel use of an angiographic compression device to stabilize the port and facilitate the adjustment procedure. CONCLUSION This technique has limited the need for multiple puncture attempts, allowed more efficient access to the port, and reduced radiation dose to the patient and operator.
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Imaging in Bariatric Surgery: A Guide to Postsurgical Anatomy and Common Complications. AJR Am J Roentgenol 2008; 190:122-35. [DOI: 10.2214/ajr.07.2134] [Citation(s) in RCA: 63] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Gastric Volvulus After Laparoscopic Adjustable Gastric Banding for Morbid Obesity. AJR Am J Roentgenol 2007; 189:1469-72. [DOI: 10.2214/ajr.05.1547] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Ellsmere J, Wells W. A system for accessing implantable medical ports in the office setting. ACTA ACUST UNITED AC 2007; 2007:3946-9. [PMID: 18002863 DOI: 10.1109/iembs.2007.4353197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
There is a need for safer and more reliable means to access to implanted ports in the office setting. We highlight this need using adjustable gastric bands as an example. We summarize the existing technology for providing the necessary needle guidance. We then describe approaches to position and orientation dependent (POD) sensing that use magnetic induction between coils. Two approaches are discussed, one based on frequency domain multiplexing and the other using Time Domain Multiplexing (TDM). We summarize the results of our experiments with prototype equipment. These results motivate a discussion of the utility of estimating the full relative position and orientation of the implant and external equipment. We then describe a port locator system based on multiple TDM POD measurements that uses an externally energized passive implant.
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Affiliation(s)
- James Ellsmere
- Gastroenterology Division, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02215, USA.
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46
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Cortés Arriagada C, Navarrete García C, Silva Fuente-Alba C. [Gastric band erosion as complication of bariatric surgery. Case report and review of the literature]. GASTROENTEROLOGIA Y HEPATOLOGIA 2007; 30:465-8. [PMID: 17949614 DOI: 10.1157/13110492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Gastric banding has become a common procedure amongst bariatric surgery techniques. Because of the possibility of using a laparoscopic route to achieve a good technical result and low complication rates, this method has become the most frequently used options in the treatment of morbid obesity in Chile. We report an uncommon complication that, if left undiagnosed, could lead to considerable morbidity and even mortality: gastric band erosion and intragastric migration. Radiologists, gastroenterologists and surgeons should be able to recognize this event to provide a prompt diagnosis.
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Carucci LR, Turner MA, Szucs RA. Adjustable laparoscopic gastric banding for morbid obesity: imaging assessment and complications. Radiol Clin North Am 2007; 45:261-74. [PMID: 17502216 DOI: 10.1016/j.rcl.2007.03.003] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Laparoscopic adjustable gastric banding (LAGB) is a safe and effective means of weight loss for patients who have morbid obesity. LAGB currently is the least invasive surgical treatment for morbid obesity. Radiologists must be aware of the expected postoperative imaging findings, the optimal technique for radiologic assessment, and the postoperative complications that may occur. In addition, because band-adjustment procedures often are performed fluoroscopically, the radiologist may play a direct role in the management of weight loss in patients following LAGB.
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Affiliation(s)
- Laura R Carucci
- Department of Radiology, Abdominal Imaging Section, Virginia Commonwealth University Medical Center, 1250 East Marshall Street, Main Hospital 3rd Floor, Room 3-417, P.O. Box 980615, Richmond, VA 23298-0615, USA.
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Abuzeid AWM, Banerjea A, Timmis B, Hashemi M. Gastric Slippage as an Emergency: Diagnosis and Management. Obes Surg 2007; 17:559-61. [PMID: 17608274 DOI: 10.1007/s11695-007-9080-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Laparoscopic adjustable gastric banding (LAGB) is an increasingly common procedure for morbid obesity. The most prevalent complication following LAGB is band slippage leading to gastric prolapse. These cases often present to the emergency department where surgeons need to appropriately diagnose and stabilize the patient, prior to any surgical intervention. It is imperative that surgeons at all levels of training implement an organized, effective acute management plan to reduce the morbidity and mortality associated with this life-threatening condition. This report highlights the case of a gastric banding patient who presented to an emergency department >1 year after a LAGB operation had been performed, with dysphagia. The diagnosis of gastric prolapse can be overlooked, with potentially serious consequences.
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Affiliation(s)
- Al-Waleed M Abuzeid
- Royal Free and University College Medical School Department of Surgery, Whittington Campus, Highgate Hill, London, UK
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Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, Greve JWM, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K. Interdisciplinary European Guidelines for Surgery for Severe (Morbid) Obesity. Obes Surg 2007; 17:260-70. [PMID: 17476884 DOI: 10.1007/s11695-007-9025-2] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Affiliation(s)
- Martin Fried
- Clinical Center for Minimally Invasive and Bariatric Surgery, Prague, Czech Republic
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Fried M, Hainer V, Basdevant A, Buchwald H, Deitel M, Finer N, Greve JWM, Horber F, Mathus-Vliegen E, Scopinaro N, Steffen R, Tsigos C, Weiner R, Widhalm K. Inter-disciplinary European guidelines on surgery of severe obesity. Int J Obes (Lond) 2007; 31:569-77. [PMID: 17325689 DOI: 10.1038/sj.ijo.0803560] [Citation(s) in RCA: 154] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
In 2005, for the first time in European history, an extraordinary Expert panel named 'The BSCG' (Bariatric Scientific Collaborative Group), was appointed through joint effort of the major European Scientific Societies which are active in the field of obesity management. Societies that constituted this panel were: IFSO - International Federation for the Surgery of Obesity, IFSO-EC - International Federation for the Surgery of Obesity - European Chapter, EASO - European Association for Study of Obesity, ECOG - European Childhood Obesity Group, together with the IOTF (International Obesity Task Force) which was represented during the completion process by its representative. The BSCG was composed not only of the top officers representing the respective Scientific Societies (four acting presidents, two past presidents, one honorary president, two executive directors), but was balanced with the presence of many other key opinion leaders in the field of obesity. The BSCG composition allowed the coverage of key disciplines in comprehensive obesity management, as well as reflecting European geographical and ethnic diversity. This joint BSCG expert panel convened several meetings which were entirely focused on guidelines creation, during the past two years. There was a specific effort to develop clinical guidelines, which will reflect current knowledge, expertise and evidence based data on morbid obesity treatment.
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Affiliation(s)
- M Fried
- Clinical Center for Minimally Invasive and Bariatric Surgery, 1st Medical Faculty, Charles University, Prague, Czech Republic.
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