Interventional radiology for post-gastrectomy complications

Abstract

Complications following gastrectomy can be life-threatening, but, they are commonly managed by interventional radiology. This review describes possible complications after gastrectomy by dividing them into vascular and non-vascular categories. Vascular complications are mostly arterial bleeding and varix bleeding. Non-vascular complications comprise abscess, fistula, benign anastomotic stricture, and malignant obstruction, e.g. afferent loop syndrome, by tumor recurrence. Interventional managements for treatment of post-gastrectomy complications are safe, effective, and less invasive compared with surgery.

Role of interventional radiology in the management of postoperative gastrointestinal leakage

“…37,43 Other than mortality, anastomotic leakage can result in decreased digestion and quality of life. [44][45][46][47][48][49][50][51][52] After a gastrectomy, the median time to diagnosis of leakage was about 7 days. [45][46][47] Endoscopy, CT imaging, or fluoroscopy using contrast agents are all * used to identify anastomotic leaking.…”

“…For a pelvic abscess, a transgluteal, transvaginal, or transrectal approach can be performed. 49,50 For enteral feeding and decompression, nasogastric tube insertion under fluoroscopic guidance is helpful. If a long period is required until tube removal, percutaneous transesophageal gastrotubing (access to the stomach via percutaneous access to the cervical esophagus) can be an alternative option to nasogastric tube (Fig.…”