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Radiological Gastroenteric Studies to Detect Complications of Surgery
About Complications Like Stomal Stenosis, Gastro-Esophageal Reflux, Pouch Dilatations, Anastomotic Leak
Radiological Gastroenteric Studies to Detect Complications After Vertical Banded Gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP) in Patients with Morbid Obesity
The aim of the study was to evaluate the role of radiological upper gastroenteric studies to detect early and postoperative complications after gastric restrictive surgery for obesity.
From October 1992 to October 2002, 650 patients submitted to vertical banded gastroplasty (VBG) and Roux-en-Y gastric bypass (RYGBP) underwent radiological follow-up to assess the presence of both early and late postoperative complications. The patients were 546 (84%) women and 104 (16%) men whose average weight was 125 kg (range: 78 to 218 kg). The average female age was 37 years (range: 17 to 69 years) and the average male age 36 (range: 19 to 64 years). Preoperative mean body mass index was 46 kg/m2 (range 31-78 kg/m2). The patients underwent radiological upper gastroenteric investigation employing water soluble contrast material between the 4th and 7th postoperative day. All patients underwent another late examination every year after surgery.
At 10 years follow-up in 620 patients submitted to modified Mason vertical banded gastroplasty we observed the following early postoperative complications: 16 cases (2.6%) of oedema of the stoma, six cases (0.9%) of gastro-oesophageal reflux, one case (0.2%) of staple-line disruption, and one case (0.2%) of intragastric haemorrhage. Late complications in vertical banded gastroplasty included 26 cases (4.2%) of staple-line disruption, four cases (0.6%) of kinked stomas, six cases (0.9%) of pouch dilatations, two cases (0.4%) of stomal stenosis and one case (0.2%) of gastro-oesophageal reflux. In 30 Roux-en-Y gastric bypass patients we observed the following early postoperative complications: one case (0.8%) of dilated pouch, one case (0.8%) of oedema of the anastomosis and one case (0.8%) of anastomotic leak. Late postoperative complications in the 30 Roux-en-Y gastric bypass patients included three cases (2.5%) of stomal ulcers and one case (0.8%) of gastro-oesophageal reflux. We also examined the annual incidence of complications in late follow-up.
Both early and late radiological studies after gastric bariatric surgery enable the detection of post-operative complications and provided morphological and volumetric data after vertical banded gastroplasty and Roux-en-Y gastric bypass. Post-operative complications (gastric perforation, stomal stenosis, etc.) need to be emphasised and the clinical approach modified to enable suitable weight loss.
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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources