Imaging after Bariatric Surgery: When Interpretation Is a Challenge, from Normal to Abnormal

Alban, Evelyn Astrid Dorado; García, Carlos; Ospina, Laura; Munevar, Hernan E

doi:10.1007/s11695-018-3334-5

Cited by 9 publications

(9 citation statements)

References 39 publications

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“…12). The success rate which indicates resolution of obstructive symptoms and passage of the endoscope without disturbance exceeds 90% in proximal and 70% in distal stenoses 203,423–434. However, serious complications including perforation are reported in 2% to 5% of cases.…”

Section: Dilation Of Distal Stenosismentioning

confidence: 99%

A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks

Gjeorgjievski¹,

Imam

Cappell

et al. 2020

Journal of Clinical Gastroenterology

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Background: Bariatric surgery leaks result in significant morbidity and mortality. Experts report variable therapeutic approaches, without uniform guidelines or consensus.Objective: To review the pathogenesis, risk factors, prevention, and treatment of gastric sleeve leaks, with a focus on endoscopic approaches. In addition, the efficacy and success rates of different treatment modalities are assessed.Design: A comprehensive review was conducted using a thorough literature search of 5 online electronic databases (PubMed, PubMed Central, Cochrane, EMBASE, and Web of Science) from the time of their inception through March 2020. Studies evaluating gastric sleeve leaks were included. MeSH terms related to "endoscopic," "leak," "sleeve," "gastrectomy," "anastomotic," and "bariatric" were applied to a highly sensitive search strategy. The main outcomes were epidemiology, pathophysiology, diagnosis, treatment, and outcomes.Results: Literature search yielded 2418 studies of which 438 were incorporated into the review. Shock and peritonitis necessitate early surgical intervention for leaks. Endoscopic therapies in acute and early leaks involve modalities with a focus on one of: (i) defect closure, (ii) wall diversion, or (iii) wall exclusion. Surgical revision is required if endoscopic therapies fail to control leaks after 6 months. Chronic leaks require one or more endoscopic, radiologic, or surgical approaches for fluid collection drainage to facilitate adequate healing. Success rates depend on provider and center expertise. Conclusion:Endoscopic management of leaks post sleeve gastrectomy is a minimally invasive and effective alternative to surgery. Their effect may vary based on clinical presentation, timing or leak morphology, and should be tailored to the appropriate endoscopic modality of treatment.

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Section: Dilation Of Distal Stenosismentioning

confidence: 99%

A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks

Gjeorgjievski¹,

Imam

Cappell

et al. 2020

Journal of Clinical Gastroenterology

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“…Extravasation of contrast into fluid collection near the sleeve indicates a leak from the staple line in a dynamic abdominal CT scan with oral contrast ( Fig. 1 ) [ 25 26 ]. Nonetheless, imaging studies can be false-negative, and hemodynamically unstable patients should undergo surgical exploration, whether with or without positive findings on CT scans.…”

Section: Leakagementioning

confidence: 99%

“… Figure reprinted from Alban et al Obes Surg 2018;28(9):2923-2931, with permission from the publisher, Springer Nature [ 26 ]. …”

Section: Leakagementioning

confidence: 99%

Diagnosis and Management of Postoperative Complications After Sleeve Gastrectomy

Park

2022

J Metab Bariatr Surg

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Sleeve gastrectomy (SG) has demonstrated excellent outcomes in terms of weight loss and resolution of obesity-related comorbidities as a single procedure. It has gained rapidly increasing popularity among bariatric surgeons and patients over the last two decades. This is due to its relative ease of use and less frequent morbidities related to the procedure. Even though the overall complication rate after SG is reported to be lower than conventional Roux-en-Y gastric bypass or biliopancreatic diversion, it still affects 1–10% of the patients undergoing SG, which is not negligible. Early postoperative complications that can occur within 30 days after SG include hemorrhage, leakage, sleeve stenosis, and reflux. Thromboembolic events are rare but can occur after surgery. Here, we review the incidence, diagnosis, and management of these early postoperative complications.

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“…In reality, CT better depicts that this complication is also valid. The treatment of resection and re-suture is laparoscopy-based [ 39 ].…”

Section: Complicationsmentioning

confidence: 99%

Common, Less Common, and Unexpected Complications after Bariatric Surgery: A Pictorial Essay

Iacobellis

Orabona²,

Brillantino³

et al. 2022

Diagnostics

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Bariatric surgery has demonstrated a higher rate of success than other nonsurgical treatments in selected patients with obesity; however, like all medical procedures, postoperative complications may occur, ranging between 2 and 10% and, although rare, they can be life threatening. Complications may be unspecific (any surgery-related complications) or specific (linked to the specific surgical procedure) and can be distinguished as common, less common, and unexpected. According to the onset, they may be acute, when occurring in the first 30 days after surgery, or chronic, with a presentation after 30 days from the procedure. The aim of this pictorial essay is to review the radiological aspects of surgical techniques usually performed and the possible complications, in order to make radiologists more confident with the postsurgical anatomy and with the normal and abnormal imaging findings.

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Imaging after Bariatric Surgery: When Interpretation Is a Challenge, from Normal to Abnormal

Cited by 9 publications

References 39 publications

A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks

A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy Leaks

Diagnosis and Management of Postoperative Complications After Sleeve Gastrectomy

Common, Less Common, and Unexpected Complications after Bariatric Surgery: A Pictorial Essay

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