Department of Diagnostic Imaging, Chaim Sheba Medical Center, Tel Hashomer, Sackler Faculty of Medicine, Tel Aviv University, 52621, Ramat Gan, Israel.
Obes Surg. 2019 Feb;29(2):499-505. doi: 10.1007/s11695-018-3534-z.
Laparoscopic adjustable gastric banding (LAGB) used to be a common procedure at the turn of the century and is still frequently encountered on CT scans in common clinical practice. Our aim is to present the frequency and spectrum of complication associated with LAGB, as observed in CT.
After approval of our institutional review board, a retrospective search for LAGB in CT interpretations using the term "band" between December 2011 and April 2017 was conducted. CT scans were reviewed to identify complications. The findings were divided into two groups: symptomatic, in which the complications caused acute symptoms for which CT scans were conducted, and incidental, in which complications were incidentally identified. The frequency of complications was calculated.
We identified 160 patients who underwent LAGB and performed a CT scan. Complications were identified in 69/160 (43.1%) patients, with a total of 83 findings: 47/160 (29.4%) esophageal dilatation, 13/160 (8.2%) pulmonary complications, 6/160 (3.8%) abdominal abscesses, 5/160 (3.1%) small bowel obstructions, 4/160 (2.5%) intragastric band erosions, 4/160 (2.5%) tube disconnections, 3/160 (1.9%) port site and tube course infections, and 1/160 (0.6%) small pouch bezoars. When compared with patients' referral notes, 38/83 (45.8%) of the findings were associated with acute symptoms, whereas 45/83 (54.2%) of the findings were incidental. Eighteen percent of the incidental complications were clinically important.
Complications were found in 43% of CT scans of patients who underwent LAGB; less than half of the findings were symptomatic. Some of the incidentally identified complications had substantial clinical importance.
腹腔镜可调节胃束带术(LAGB)在本世纪初较为常见,在临床实践中仍经常在 CT 扫描中发现。我们的目的是展示在 CT 中观察到的与 LAGB 相关的并发症的频率和范围。
在获得我们机构审查委员会的批准后,我们对 2011 年 12 月至 2017 年 4 月间使用“带”一词在 CT 解读中搜索 LAGB 进行了回顾性搜索。对 CT 扫描进行了回顾,以确定并发症。将这些发现分为两组:有症状的,其中并发症引起了进行 CT 扫描的急性症状;和偶发的,其中并发症是偶然发现的。计算并发症的频率。
我们共识别出 160 例接受 LAGB 并进行 CT 扫描的患者。在 69/160(43.1%)例患者中发现了并发症,共 83 种表现:47/160(29.4%)食管扩张,13/160(8.2%)肺部并发症,6/160(3.8%)腹部脓肿,5/160(3.1%)小肠梗阻,4/160(2.5%)胃内带侵蚀,4/160(2.5%)管断开,3/160(1.9%)端口和管路径感染,1/160(0.6%)小袋胃石。与患者的转诊记录相比,83 个表现中有 38/83(45.8%)与急性症状有关,而 45/83(54.2%)为偶发表现。偶发并发症中有 18%具有重要的临床意义。
在接受 LAGB 的患者的 CT 扫描中发现了 43%的并发症;不到一半的表现是有症状的。一些偶然发现的并发症具有重要的临床意义。