MDCT of retractor-related hepatic injury following laparoscopic surgery: appearances, incidence, and follow-up
| Autor: | K.E. Orr, M.P. Williams |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Laparoscopic surgery
Adult Male medicine.medical_specialty Liver atrophy medicine.medical_treatment Bariatric Surgery Malignancy Malignant disease Young Adult Atrophy Multidetector Computed Tomography medicine Humans Radiology Nuclear Medicine and imaging Intraoperative Complications Aged Gastrointestinal Neoplasms Retrospective Studies Aged 80 and over business.industry Incidence (epidemiology) Retrospective cohort study General Medicine Middle Aged medicine.disease Surgery Retractor Liver Female Laparoscopy Radiology business Follow-Up Studies |
| Zdroj: | Clinical radiology. 69(6) |
| ISSN: | 1365-229X |
| Popis: | Aims To investigate the postoperative computed tomography (CT) features resulting from the use of Nathanson retractors during laparoscopic upper gastro-intestinal surgery. Materials and methods A 3-year retrospective study of 176 patients who had undergone laparoscopic upper gastro-intestinal surgery for bariatric or malignant disease was performed. Postoperative CT images [divided into early (≤30 days) and late (>30 days)] were assessed by a consultant radiologist and liver abnormalities recorded. Results The features of a retractor injury were a hypodense lesion, abutting the liver edge, usually triangular or linear in shape. Late postoperative features included focal subcapsular retraction and associated liver atrophy. Sixty-eight percent (52/77) of patients undergoing surgery for malignancy underwent postoperative CT, compared with 11% (11/99) of those undergoing bariatric surgery. Patients with malignancy were more likely to have retraction-related liver abnormalities (14/52, 27%) at postoperative CT than those in the bariatric group (2/11, 18%). Conclusion Retractor-related liver injuries at MDCT are common following laparoscopic upper gastro-intestinal surgery. Recognition of the characteristic triad of features, a hypodense lesion abutting the liver edge with a triangular or linear shape, should allow confident diagnosis. CT follow-up reveals that over time these lesions may disappear, remain unchanged, or result in a focal subcapsular scar with associated atrophy. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect