Common Postoperative Findings Unique to Laparoscopic Surgery

Hindman, Nicole; Kang, Stella K.; Parikh, Manish

doi:10.1148/rg.341125181

Cited by 33 publications

(46 citation statements)

References 65 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Nowadays, in most post-surgical situations, multidetector CT rapidly and consistently provides panoramic visualization of postoperative abdominal changes, and generally adds crucial information for diagnosis of iatrogenic complications [10, 11, 26]. …”

Section: Early Post-gastrectomy Imaging: Techniques and Normal Appearmentioning

confidence: 99%

“…Conversely, persisting or increasing gas raises concern for anastomotic dehiscence or visceral perforation. Following laparoscopy, the amount of expected intraperitoneal air is less compared to open surgery, because insufflated CO2 is rapidly absorbed; conversely, subcutaneous emphysema may result from insufflation in the abdominal wall [26, 27]. …”

Section: Early Post-gastrectomy Imaging: Techniques and Normal Appearmentioning

confidence: 99%

See 1 more Smart Citation

Early postoperative imaging after non-bariatric gastric resection: a primer for radiologists

Tonolini

Bracchi

2017

Insights Imaging

View full text Add to dashboard Cite

Surgical resection represents the mainstay treatment and only potentially curative option for gastric carcinoma, and is increasingly performed laparoscopically. Furthermore, other tumours and selected cases of non-malignant disorders of the stomach may require partial or total gastrectomy. Often performed in elderly patients, gastric resection remains a challenging procedure, with significant morbidity (14–43% complication rate) and non-negligible postoperative mortality (approximately 3%). This paper provides an overview of contemporary surgical techniques for non-bariatric gastric resection, reviews and illustrates the expected postoperative imaging appearances, common and unusual complications after partial and total gastrectomy. Albeit cumbersome or unfeasible in severely ill or uncooperative patients, contrast fluoroscopy remains useful to rapidly check for anastomotic patency and integrity. Currently, emphasis is placed on multidetector CT, which comprehensively visualizes the surgically altered anatomy and consistently detects complications such as anastomotic leaks and fistulas, duodenal stump leakage, afferent loop syndrome, haemorrhages, pancreatic fistulas and porto-mesenteric venous thrombosis. Our aim is to help radiologists become familiar with early postoperative imaging, in order to understand the surgically altered anatomy and to differentiate between expected imaging appearances and abnormal changes heralding iatrogenic complications, thus providing a consistent basis for correct choice between conservative, interventional or surgical treatment.Teaching points• Radical gastrectomy is associated with frequent postoperative morbidity and non-negligible mortality. • In cooperative patients fluoroscopy allows checking for anastomotic patency and leaks. • Multidetector CT with / without oral contrast comprehensively visualizes the operated abdomen. • Awareness of surgically altered anatomy and expected postoperative appearances is warranted. • Main complications include anastomotic and duodenal leaks, haemorrhages and pancreatic fistulas.

show abstract

Section: Early Post-gastrectomy Imaging: Techniques and Normal Appearmentioning

confidence: 99%

Section: Early Post-gastrectomy Imaging: Techniques and Normal Appearmentioning

confidence: 99%

Early postoperative imaging after non-bariatric gastric resection: a primer for radiologists

Tonolini

Bracchi

2017

Insights Imaging

View full text Add to dashboard Cite

show abstract

“…5 Most commonly, bile leaks into the peritoneal cavity and appears as free fluid in the upper right quadrant subhepatic space.…”

Section: Endgamesmentioning

confidence: 99%

Abdominal pain after surgery

Sheikh

Ahmad

Pallan

2017

BMJ

View full text Add to dashboard Cite

“…8). Additionally, contrast medium extravasation indicating ongoing hemorrhage may be occasionally identified (7,11,17).…”

Section: Hemorrhagementioning

confidence: 99%

“…10) of extraluminal contrast leakage indicating perforation (18). While large bladder defects need repair, small mural defects can be managed conservatively with catheter bladder decompression (4,5,11).…”

Section: Urogenital Injuriesmentioning

confidence: 99%

Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

Tonolini

2016

Diagn Interv Radiol

View full text Add to dashboard Cite

A rguably the most frequent general surgery procedure, inguinal hernia repair (IHR) reaches an annual rate of approximately 200 operations per 100.000 people/years. Since the introduction of the open-mesh IHR by Lichtenstein in 1989, tension-free hernioplasty with prosthetic mesh (PM) implantation became the standard of care and decreased the likelihood of recurrence by approximately 50%. Furthermore, the increasing use of laparoscopy in IHR allows faster recovery, decreased postoperative pain, lower risk of postoperative seroma, wound infection and hemorrhage, lower incidence of chronic pain and long-term hernia recurrence-at the price of longer operative time and higher risk of rare yet serious visceral injuries (1-5).Since most general hospitals perform hundreds of IHR procedures each year, radiologists are increasingly requested to investigate suspected iatrogenic complications (6, 7).Some authors recommend ultrasonography (US) as a helpful first-line modality to assess the operated groin, which allows rapid and confident detection of anechoic fluid seromas abutting the PM. However, US is often hampered by obesity, thickened subcutaneous fat, medications, and local tenderness at the surgical wound. Furthermore, hypo-anechoic or septated collections corresponding to hematomas or abscesses are sonographically challenging to interpret (7,8).During the last decade, some focused radiologic reports described the expected postsurgical computed tomography (CT) appearances after PM-IHR, particularly the characteristic pseudolesions which are discussed in-depth in a dedicated section of this paper (6, 9). Conversely, very limited literature exists on cross-sectional imaging of iatrogenic complications, mostly including a 2004 review based on axial CT (10) and a recent paper generally devoted to imaging complications related to laparoscopic access (11).This paper provides an overview of contemporary IHR, reviews and illustrates the expected postoperative imaging appearances and iatrogenic injuries with emphasis on multidetector CT findings. Overview of surgical techniquesAs recent studies estimated a very low (<1%) risk of incarceration, a reducible inguinal hernia is not an indication for surgery unless the patient complains of pain or discomfort. E M E R G E N C Y R A D I O LO G Y P I C TO R I A L E S S AY ABSTRACTInguinal hernia repair (IHR) with prosthetic mesh implantation is the most common procedure in general surgery, and may be performed using either an open or laparoscopic approach. This paper provides an overview of contemporary tension-free IHR techniques and materials, and illustrates the expected postoperative imaging findings and iatrogenic injuries. Emphasis is placed on multidetector CT, which represents the ideal modality to comprehensively visualize the operated groin region and deeper intra-abdominal structures. CT consistently depicts seroma, mesh infections, hemorrhages, bowel complications and urinary bladder injuries, and thus generally provides a consistent basis for therapeutic choice. Since ...

show abstract

Common Postoperative Findings Unique to Laparoscopic Surgery

Cited by 33 publications

References 65 publications

Early postoperative imaging after non-bariatric gastric resection: a primer for radiologists

Early postoperative imaging after non-bariatric gastric resection: a primer for radiologists

Abdominal pain after surgery

Multidetector CT of expected findings and complications after contemporary inguinal hernia repair surgery

Contact Info

Product

Resources

About