Radiology of adjustable silicone gastric banding for morbid obesity.

Abstract

We reviewed the radiological findings in 45 morbidly obese patients (weight range 80-129 kg; mean 95.7 kg) after gastric restriction surgery with adjustable silicone gastric banding (ASBG) according to the Kuzmak technique. Radiographic studies of the stomach were performed before, and at 4 and 12 months after surgery; symptomatic patients underwent additional studies when needed. Patients were evaluated using both liquid barium and a solid opaque meal to assess post-operative gastric morphology as well as emptying time of the proximal gastric pouch. 27 patients had a normal clinical course. Variation of the calibre of the silicone band under radiographic guidance was required in 12 of these patients, based on dilatation of the proximal pouch, variation of the stomal calibre from operative values, or an emptying time longer than 30 min. All these problems disappeared after the adjustment manoeuvres. 18 patients had complications, of which five had stomal stenosis which could not be managed through simple deflation of the band; two had posterior bending and dilatation of the proximal pouch; four had gastritis and oesophagitis; six had infection of the inflatable reservoir; one had cranial displacement of the band, and two had migration of the band into the stomach. Removal of the gastric band was necessary in 11 cases, and removal of the reservoir alone had to be performed in three additional patients. Radiology plays an important role in evaluating complications after gastric restriction surgery. Knowing the variety of findings enables accurate treatment planning and follow-up of these patients.

Intraluminal penetration of the band in patients with adjustable silicone gastric banding: radiological findings

“…Radiology plays an important role in ASGB patients: it can be used to monitor stomal adjustments through inflation or deflation of the band, and is requested in symptomatic cases to demonstrate complications [8,9,10]. The radiological appearances of a large variety of pathological conditions, including stenosis of the stoma, infection, and band slippage, have been described in these patients.…”

“…Radiological techniques have been proven to be useful in identifying both early and late postoperative complications and to guide proper patient management [8,9,10]. In this paper will describe the radiographic findings observed in four patients with penetration of the band into the gastric lumen, a relatively rare major problem requiring band removal, which has been recently brought to clinical attention [3,5,6,7].…”

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

“…The stoma diameter should measure approximately 3-4 mm in diameter, with prompt emptying of the pouch [24]. In addition, the adjustable band, catheter and subcutaneous port can all be visualised.…”

Assessment of the Relationship Between Post-meal Satiety, Gastric Volume and Gastric Emptying After Swedish Adjustable Gastric Banding. A Pilot Study Using Magnetic Resonance Imaging to Assess Postsurgery Gastric Function

“…Gamma scintography provides limited image resolution and can not be repeated frequently due to the associated radiation dose. Barium studies lack the ability to give volume measurements and ultrasound studies are limited by the interference from the gas/fluid interfaces present in the stomach [11][12][13]. In addition, these early studies also investigated predominately vertical banded gastroplasty (VBG) and gastric bypass, concluding that gastric emptying rate was not altered in the modified stomach after bariatric surgery.…”