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诊断性影像学在减重手术急性并发症诊断中的应用

Diagnostic imaging in the diagnosis of acute complications of bariatric surgery.

作者信息

Catelli Antonio, Corvino Antonio, Loiudice Giovanni, Tucci Anna, Quarantelli Mario, Venetucci Pietro

机构信息

Advanced Biomedical Sciences Department, University Federico II of Naples (UNINA), Naples, Italy.

Motor Science and Wellness Department, University of Naples "Parthenope", Naples, Italy.

出版信息

Pol J Radiol. 2021 Feb 9;86:e102-e111. doi: 10.5114/pjr.2021.104003. eCollection 2021.

DOI:10.5114/pjr.2021.104003
PMID:33758635
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7976234/
Abstract

PURPOSE

The aim of study is to identify the frequency of acute complications and imaging findings at gastro-intestinal transit (GI) and computerised tomography (CT) in a group of obese patients who developed clinical suspicion of acute complications (painful and meteoric abdomen, nausea, vomiting, fever, intestinal blockage) in post bariatric surgery.

MATERIAL AND METHODS

We retrospectively review 954 obese patients who underwent bariatric surgery between 2013 and 2019. The study included 72 patients who developed clinical suspicion of acute complications (painful and meteoric abdomen, nausea, vomiting, fever, intestinal blockage) within 6 days of bariatric surgery of sleeve gastrectomy, gastric banding, gastric bypass with Roux loop confirmed by CT, and who underwent a gastrointestinal transit before the CT examination.

RESULTS

GI exam allowed visualisation of 58% of complications. Analysing the data for each surgical technique, 46 post-operative complications were found involve gastric banding. The most frequent was bandage migration (26 cases, 56 %), identified in all cases at GI transit and then confirmed on CT.

CONCLUSIONS

The study suggests that CT should be used to clarify all doubtful or clinically discordant GI transit exam results. The participation of a radiologist in qualification and post-operative evaluation is important for bariatric surgery patients.

摘要

目的

本研究旨在确定一组肥胖患者在接受减重手术后出现急性并发症临床疑似症状（腹痛、腹胀、恶心、呕吐、发热、肠梗阻）时，胃肠道造影（GI）和计算机断层扫描（CT）检查中急性并发症的发生率及影像学表现。

材料与方法

我们回顾性分析了2013年至2019年间接受减重手术的954例肥胖患者。该研究纳入了72例在袖状胃切除术、胃束带术、Roux袢胃旁路术后6天内出现急性并发症临床疑似症状（腹痛、腹胀、恶心、呕吐、发热、肠梗阻）且经CT证实，并在CT检查前进行了胃肠道造影的患者。

结果

GI检查能够发现58%的并发症。分析每种手术技术的数据，发现46例术后并发症与胃束带术有关。最常见的是束带移位（26例，56%），所有病例在GI造影时均被发现，随后经CT证实。

结论

该研究表明，对于所有可疑或临床结果不一致的GI造影检查结果，均应使用CT进行明确。放射科医生参与减重手术患者的术前评估和术后评估非常重要。

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