Stenosis of gastric sleeve after laparoscopic sleeve gastrectomy: clinical, radiographic and endoscopic findings
| Autor: | Kristoffel R. Dumon, Noel N. Williams, Marc S. Levine, Stephen E. Rubesin, Jennifer L Levy |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male Sleeve gastrectomy medicine.medical_specialty Adolescent The role of imaging in obesity special feature: Full Paper Radiography medicine.medical_treatment 030209 endocrinology & metabolism Constriction Pathologic Young Adult 03 medical and health sciences Stomach surgery Postoperative Complications 0302 clinical medicine Gastrectomy Gastric Stump Gastroscopy medicine Barium Radioisotopes Humans Radiology Nuclear Medicine and imaging Laparoscopy Aged Retrospective Studies medicine.diagnostic_test business.industry Stomach General Medicine Middle Aged medicine.disease Endoscopy Surgery Stenosis medicine.anatomical_structure Female 030211 gastroenterology & hepatology business |
| Zdroj: | The British Journal of Radiology. :20170702 |
| ISSN: | 1748-880X 0007-1285 |
| DOI: | 10.1259/bjr.20170702 |
| Popis: | OBJECTIVE: To determine the clinical, radiographic, and endoscopic findings of sleeve stenosis after sleeve gastrectomy and to correlate treatment with outcomes. METHODS: We identified 43 patients who underwent barium studies to evaluate upper GI symptoms after laparoscopic sleeve gastrectomy. The clinical, radiographic, and endoscopic findings were reviewed and correlated with treatment and outcomes. RESULTS: 26 patients (60%) had sleeve stenoses. All stenoses appeared as short segments of smooth, tapered narrowing, with a mean length of 8.0 mm and mean width of 7.5 mm, and 24 (92%) were located in the proximal or distal third of the sleeve. 23 patients (88%) had upstream dilation, and 1 (4%) had retained food proximal to the stenosis. 23 (70%) of 33 patients with obstructive symptoms and 3 (30%) of 10 without obstructive symptoms had sleeve stenoses. Endoscopy revealed sleeve stenosis in 8 (67%) of 12 patients with radiographic stenosis. Endoscopic dilation resulted in improvement/resolution of symptoms in seven (88%) of 8 patients. CONCLUSION: Sleeve stenosis after sleeve gastrectomy was characterized radiographically by a short segment of smooth, tapered narrowing, typically in the proximal or distal third of the sleeve. Approximately, 70% of patients with obstructive symptoms and 30% with non-obstructive symptoms had sleeve stenosis. One-third of radiographically diagnosed stenoses were not seen at endoscopy. The barium study, therefore, is a useful test for sleeve stenosis in patients with obstructive or nonobstructive symptoms after sleeve gastrectomy. ADVANCES IN KNOWLEDGE: This article describes the appearance and location of sleeve stenoses after laparoscopic sleeve gastrectomy and the clinical presentation and treatment options for these patients. |
| Databáze: | OpenAIRE |
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