Radiological evaluation of postoperative complications after non-sleeve gastrectomy bariatric procedures

Abstract

Background: Obesity is a medical condition, which may lead to serious related diseases, ultimately, resulting in many morbidities and early mortality. Its management involves many approaches of which bariatric surgery is considered nowadays as one of the most effective treatment for it. However, follow up of postoperative complications of this surgery by effective radiological method as computed tomography (CT) is important for assessment of its success.
Objective: The aim of this study was to illuminate the radiological signs and features of postoperative complications after non sleeve bariatric procedures and stressing the importance of using multi-slice CT (MSCT), and fluoroscopic study for detection of these complications. Patients and methods: An observational cohort study for 275 patients with suspected complications after non sleeve gastrectomy bariatric procedures, including 195 patients after Roux-en-Y gastric bypass (RYGB), 76 patients after laparoscopic adjustable gastric banding (LAGB) and 4 patients after intragastric balloon placement was done. These patients were subjected to either multi-slice CT and or fluoroscopy. Results: We detected complications in 21 patients out of the 195 patients who underwent RYGB: leakage, abscess, intestinal obstruction, internal hernia, port site ventral hernia, intussusception, fistula between the gastric pouch and the excluded stomach and hiatus hernia. On the other hand, 8 out of 76 patients operated by LAGB developed complications: band slippage, band erosion, pouch dilatation and tubal disconnection. Lastly two out of the 4 patients who placed intra-gastric balloon encountered other complications: gastric outlet obstruction, spontaneous balloon deflation and distal migration with intestinal obstruction.
Conclusion: It could be concluded that bariatric procedures may be followed by many complications and accurate diagnosis of these problems by proper radiological procedures as MSCT is imperative.