Aims and objectives
The purpose of this study is to illustrate the gastric leakages as complication in patients undergoing to bariatric surgery,
laparoscopic sleeve gastrectomy (LSG),
evaluated by multidetector computer tomography (MDCT),
especially assessing the role of MDCT in the detection and in therapeutic planning.
Methods and materials
348 patients undergoing laparoscopic sleeve gastrectomy (244 female,
mean age 40.37 years old),
from January 2011 to December 2016,
were evaluated by radiographic upper gastrointestinal (UGI) series in the early post-operative period (3th day). In presence of reasonable clinical suspect of gastric leakage (abdominal pain,
fever >38,5 °C,
tachycardia >100 bpm,
leucocytosis) 29 MDTC were carried out. The exams have been extended to include the chest,
to rule out...
The radiographic visualization of gastric leakage was observed in only 1 patient (0,3%). 7 cases of leakage (2%) were diagnosed by MDCT and treated with surgical,
interventional radiological or conservative treatment: 2 early (1-3 days after surgery),
2 intermediate (4-7 days after surgery) and 3 late leaks (≥8 days after surgery). Two types of leakage were observed: leakages with diffuse peritoneal spread of contrast,
and localized leaks without contrast spread.
The last ones commonly occur...
The laparoscopic sleeve gastrectomy is one of the most common bariatric procedures. LSG can be associated with three significant complications,
gastric leaks and gastric strictures.
Of these the gastric leakage is the most feared complication.
Gastric leaks are associated with increase of hospitalization time,
morbidity and mortality.
The leak can lead to significant morbidity such as sepsis,
multiple organ failure (M.O.F.) and even death in 0-1,4%...
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Silecchia G (2016).
Leaks after laparoscopic sleeve gastrectomy: overview of pathogenesis and risk factors.
Langenbecks Arch Surg 401 (6): 757-66. 2) Mittermair R,
Wykypiel H (2014).
Routine upper gastrointestinal swallow studies after laparoscopic sleeve gastrectomy are unnecessary.
Am J Surg.
207: 897-901. 3) Rached AA,
El Masri H (2014) Gastric leaks post sleeve gastrectomy: review of its prevention and management....