Section of Abdominal Imaging, Imaging Institute, Cleveland Clinic, 9500 Euclid Ave, A21, Cleveland, OH 44195, USA.
AJR Am J Roentgenol. 2013 Aug;201(2):W262-70. doi: 10.2214/AJR.12.9385.
The purpose of this article is to assess normal imaging findings and complications after laparoscopic greater curvature plication on luminal upper gastrointestinal studies and CT.
This was a retrospective chart review of 24 adults who underwent laparoscopic greater curvature plication between 2008 and 2011. Seventeen patients (70.8%) underwent postoperative luminal upper gastrointestinal studies, and four (16.7%) underwent postoperative CT. Normal imaging features and complications were recorded. The percentage of intraluminal gastric diameter occupied by the plicated segment and the percentage of greater curvature involved on postoperative upper gastrointestinal luminal studies were determined.
A multilobular intraluminal filling defect reflecting the surgical plication occupied the proximal third of the greater curvature in 16 of 17 patients (94%), extending to the mid portion in 10 of 17 patients (59%) and to the distal third in one of 17 patients (6%). There was luminal narrowing of 50-75% in 14 of 17 patients (82%) and narrowing of 25-50% in two patients (12%). In 14 of 17 patients (82%), the plication involved 50-75% of the greater curvature length and 25-50% in the remaining three patients (18%). In four patients who underwent CT, a central low-attenuation stripe accompanied the plication. Five of 24 patients (21%) had complications, including extraluminal gastric leak (n = 1), gastric outlet obstruction (n = 2), and plication suture failure (n = 2).
Laparoscopic greater curvature plication is seen as multilobular filling defects most commonly along the proximal greater curvature with 50-75% narrowing of the gastric lumen. A linear low-attenuation stripe accompanies the filling defect on CT.
本文旨在评估腹腔镜胃大弯折叠术在上消化道内腔研究和 CT 后的正常影像学表现和并发症。
这是一项对 2008 年至 2011 年间接受腹腔镜胃大弯折叠术的 24 例成年人的回顾性图表研究。17 例患者（70.8%）接受了术后内腔上消化道研究，4 例（16.7%）接受了术后 CT。记录了正常影像学特征和并发症。确定术后内腔上消化道研究中折叠段腔内胃直径的百分比和胃大弯受累的百分比。
17 例患者中有 16 例（94%）的近端三分之一胃腔内可见反映手术折叠的多小叶充盈缺损，延伸至 10 例患者中的中三分之一（59%）和 17 例患者中的远三分之一（6%）。17 例患者中有 14 例（82%）存在 50-75%的内腔狭窄，2 例患者（12%）存在 25-50%的内腔狭窄。在 17 例患者中，14 例（82%）的折叠涉及胃大弯长度的 50-75%，其余 3 例（18%）涉及 25-50%。在接受 CT 的 4 例患者中，折叠处伴有中央低衰减条纹。24 例患者中有 5 例（21%）发生并发症，包括胃外漏（1 例）、胃出口梗阻（2 例）和折叠缝线失败（2 例）。
腹腔镜胃大弯折叠术表现为多小叶充盈缺损，最常见于胃大弯近端，胃腔狭窄 50-75%。CT 上的充盈缺损伴有线性低衰减条纹。
