Laparoscopic Adjustable Gastric Banding Surgery for Morbid Obesity: Imaging of Normal Anatomic Features and Postoperative Gastrointestinal Complications

Abstract

With the increasing prevalence of morbid obesity, laparoscopic adjustable gastric banding surgery has evolved to be a leading surgical technique. Radiologists need to be familiar with the normal anatomic findings after laparoscopic adjustable gastric banding surgery and with the imaging findings of postoperative complications.

Imaging in bariatric surgery: service set-up, post-operative anatomy and complications

“…Normally this angle should range from 4˚to 58˚ [25]. Stomal stenosis and acute concentric pouch dilatation are the most common complications after LAGB [26], and present with nocturnal reflux, vomiting and upper abdominal discomfort. It may be due to iatrogenic overfilling of the band, post-operative stomal oedema or blockage of the stoma by food bolus.…”

“…Chronic pouch dilatation incidence is 3-8% [26,27]. In contrast to acute pouch dilatation, it occurs in the presence of a normal stoma and is usually owing to chronic volume overload of the pouch secondary to overeating.…”

“…Incidence ranges from 3% to 13% and is decreasing with modifications to the surgical technique [26][27][28][29]. Anterior prolapse is more common and results in lateral eccentric gastric pouch enlargement, stomal narrowing and a horizontally orientated band, with a phi angle of greater than 58 ( Figure 9) [11,30].…”

“…Port-and band-related complications are reported in 0-7% of cases, and include leakage, infection and band erosion [26]. Leakage can occur from the band, catheter or access port and should be suspected when there is loss of eating restriction or insufficient deflation volume.…”

“…Acute gastric perforation is rare, occurring in ,1% of cases, and is usually owing to surgical trauma to the stomach wall [26,28]. It has an extremely variable clinical presentation and can lead to life threatening sepsis.…”