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. 2018 Jan 28;10(1):1-6.
doi: 10.4329/wjr.v10.i1.1.

Computed tomography as primary postoperative follow-up after laparoscopic Roux-en-Y gastric bypass

Tarik Delko  1 , Diana Mattiello  2 , Thomas Koestler  2 , Urs Zingg  2 , Silke Potthast  3
Affiliations

Computed tomography as primary postoperative follow-up after laparoscopic Roux-en-Y gastric bypass

Tarik Delko et al. World J Radiol. .

Abstract

Aim: To evaluate upper abdominal computed tomography (CT) scan as primary follow-up after laparoscopic Roux-en-Y gastric bypass (LRYGB).

Methods: This prospective study was approved by the Ethical Committee of the State of Zurich, and informed consent was obtained from all patients. Sixty-one patients who underwent LRYGB received upper abdominal CT on postoperative day 1, with the following scan parameters: 0.6 mm collimation, 1.2 mm pitch, CareKV with reference 120 mAs and 120 kV, and 0.5 s rotation time. Diluted water-soluble radiographic contrast-medium (50 mL) was administered to achieve gastric pouch distension without movement of the patient. 3D images were evaluated to assess postoperative complications and the radiation dose received was analysed.

Results: From the 70 patients initially enrolled in the study, 9 were excluded from analysis upon the intraoperative decision to perform a sleeve gastrectomy and not a LRYGB. In all of the 61 patients who were included in the analysis, CT was feasible and there were no instances of aspiration or vomiting. In 7 patients, two upper abdominal scans were necessary as the pouch was not distended by contrast medium in the first acquisition. Radiologically, no leak and no relevant stenosis were found on the first postoperative day. These early postoperative CT findings were consistent with the findings at clinical follow-up 6 wk postoperatively, with no leaks, stenosis or obstructions being diagnosed. The average total dose length product in CT was 536.6 mGycm resulting in an average effective dose of 7.8 mSv. The most common surgical complication, superficial surgical site infections (n = 4), always occurred at the upper left trocar site, where the circular stapler had been introduced.

Conclusion: Early LRYGB postoperative multislice spiral CT scan is feasible, with low morbidity, and provides more accurate anatomical information than standard upper gastrointestinal contrast study.

Keywords: Abdominal computed tomography; Anastomotic leak; Laparoscopic proximal Roux-en-Y gastric bypass; Stenosis; Upper gastrointestinal study.

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Conflict of interest statement

Conflict-of-interest statement: All authors of this manuscript declare no conflicts of interest (financial and non-financial) with any companies, whose products or services may be related to the subject matter of the article.

Figures

Figure 1
Figure 1
Scout view with depicted scan length.
Figure 2
Figure 2
Proximal anastomosis with oral contrast-filled pouch. A: Axial; B: Coronal; C: Sagittal.
See this image and copyright information in PMC

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