Prospective evaluation of routine early computed tomography scanner in laparoscopic sleeve gastrectomy

Laïnas, Panagiotis; Tranchart, Hadrien; Gaillard, M.; Ferretti, Stefano; Donatelli, Gianfranco; Dagher, Ibrahim

doi:10.1016/j.soard.2016.03.031

Cited by 27 publications

(17 citation statements)

References 32 publications

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“…The results found that a POD 2 abdominal CT scan is an efficient diagnostic tool for detecting active bleeding/hematoma but shows less impressive results with a gastric staple line leak detection. A combination of clinical surveillance and early imaging allowed prompt management of complicated cases, avoiding further morbidity (22). The safety and feasibility of mini-laparoscopic cholecystectomy (mini-Lch) has not been documented with a large patient sample.…”

Section: Resultsmentioning

confidence: 99%

Single-incision laparoscopy surgery: a systematic review

Far¹,

Miraj²

2016

Electron physician

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BackgroundLaparoscopic surgery is a modern surgical technique in which operations are performed far from their location through small incisions elsewhere in the body.ObjectiveThis systematic review is aimed to overview single-incision laparoscopy surgery.MethodsThis systematic review was carried out by searching studies in PubMed, Medline, Web of Science, and IranMedex databases. The initial search strategy identified about 87 references. In this study, 54 studies were accepted for further screening and met all our inclusion criteria [in English, full text, therapeutic effects of single-incision laparoscopy surgery and dated mainly from the year 1990 to 2016]. The search terms were “single-incision,” “surgery,” and “laparoscopy.”ResultsSingle-incision laparoscopy surgery is widely used for surgical operations in cholecystectomy, sleeve gastrectomy, cholecystoduodenostomy, hepatobiliary disease, colon cancer, obesity, appendectomy, liver surgery, rectosigmoid cancer, vaginal hysterectomy, vaginoplasty, colorectal lung metastases, pyloroplasty, endoscopic surgery, hernia repair, nephrectomy, rectal cancer, colectomy and uterus-preserving repair, bile duct exploration, ileo-ileal resection, lymphadenectomy, incarcerated inguinal hernia, anastomosis, congenital anomaly, colectomy for cancer.ConclusionBased on the findings, single-incision laparoscopy surgery is a scarless surgery with minimal access. Although it possesses lots of benefits, including less incisional pain and scars, cosmesis, and the ability to convert to standard multiport laparoscopic surgery, it has some disadvantages, for example, less freedom of movement, fewer number of ports that can be used, and the proximity of the instruments to each other during the operation.

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Section: Resultsmentioning

confidence: 99%

Single-incision laparoscopy surgery: a systematic review

Far¹,

Miraj²

2016

Electron physician

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“…This was identified by performing CT on postop day 2 (POD2). 2 In a study by Sakran et al, 25 patients had leak from zero to >7 post-operative days. They resolved after treating by multiple modalities like image guided percutaneous drainage, endoscopic stenting, clipping etc.…”

Section: Discussionmentioning

confidence: 98%

“…The post-operative complications are leaks in the staple line, hemorrhage and stenosis. 2 In the past, upper gastro-intestinal (UGI) swallow studies were used to assess the leaks post-operatively. Currently UGI imaging endoscopy and computed tomography (CT) are used to assess the post-operative leaks, in order to plan an accurate management of those early complications of the procedure.…”

mentioning

confidence: 99%

Post-operative CT imaging of laparoscopic sleeve gastrectomy: our initial experience

Varaprasad

Manchikanti

Kongara³

2019

Int Surg J

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Background: Laparoscopic sleeve gastrectomy (LSG) is a restrictive type of bariatric surgery. It is safe and effective with its many advantages like relative simplicity of the procedure, lack of malabsorption component and anastomoses and retaining the anatomical gastrointestinal continuity. Obesity, a chronic disease, with the significant rise of its comorbidities and mortality is attributing to the major financial and health burden globally. Methods: We conducted a prospective study of over 43 patients (male 32, female 11) over 5 years period i.e., from 2012 to 2017. These patients were assessed with contrast enhanced computerized tomography (CECT) for detection of post-operative complications.Results: The patients with the body mass index (BMI) >40 kg/m2 and or with a BMI >35 and <40 kg/m2 but with significant weight related comorbidities underwent Laparoscopic sleeve gastrectomy. Both intravenous (IV) and oral contrasts are used accordingly. With increasing number of surgeries and with associated co-morbidities complications following LSG are increasing, necessitating the need for a good understanding of clinical symptoms and post-operative complications of LSG. Post-operative imaging plays a crucial role in the early detection of complications resulting in reduced mortality rate.Conclusions: We suggest multidetector computed tomography (CT) with oral and IV contrast as an excellent tool for the patients having a nonspecific abdominal symptom post LSG.

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“…Early detection of gastric leak is crucial because it enables early management, leads to decreased morbidity, and improves patient outcomes. [6,[13][14][15] A high clinical index of suspicion is the most sensitive approach to detect gastric leak. [16][17][18] e clinical presentation is highly variable, ranging from asymptomatic to septic shock.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12] Routine early computed tomography (CT) using an oral contrast agent done on post-operative day 2 also has a limited role in the detection of asymptomatic gastric leak due to the fact that gastric leak usually occurs 1-2 weeks post-sleeve gastrectomy. [13] Normal post-operative CT shows a residual gastric sleeve with a staple line along with the transection site. No contrast leak, gas leak or collection in contact with the staple line [ Figure 1].…”

Section: Introductionmentioning

confidence: 99%

Computed Tomography-based Diagnosis of Post-laparoscopic Sleeve Gastrectomy Gastric Leak

Alharbi¹

2020

JCIS

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Objective: Gastric leak post-laparoscopic sleeve gastrectomy may appear as a variety of computed tomography (CT) findings. We aimed to review the various CT findings sensitivity and specificity in confirmed cases of gastric leak. Materials and Methods: A retrospective review was performed for all patients who underwent sleeve gastrectomy, CT, and endoscopy for suspected leak between 2011 and 2018. All patients with positive CT findings for gastric leak were included in the study. Results: A total of 152 consecutive patients underwent CT for suspected post-sleeve gastrectomy gastric leak. Out of 152 patients, 88 had positive CT findings for gastric leak and underwent endoscopy. The CT findings sensitivity and specificity of perigastric collection without oral contrast leak were 61% and 88.8%, oral contrast leak were 28% and 100%, and gas leak were 10% and 77.7%, respectively. Conclusions: Perigastric fluid collection without contrast leak and with variable wall enhancement and gas content is the most common CT findings of post-sleeve gastrectomy gastric leak. Among various CT findings, it exhibits good diagnostic accuracy with 61% sensitivity and 88.8% specificity.

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Prospective evaluation of routine early computed tomography scanner in laparoscopic sleeve gastrectomy

Cited by 27 publications

References 32 publications

Single-incision laparoscopy surgery: a systematic review

Single-incision laparoscopy surgery: a systematic review

Post-operative CT imaging of laparoscopic sleeve gastrectomy: our initial experience

Computed Tomography-based Diagnosis of Post-laparoscopic Sleeve Gastrectomy Gastric Leak

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