Post-operative assessment of Bariatric Surgery by fluoroscopy and MDCT

Abstract

Imaging of bariatric surgery is a challenge. It is not an easy to early understanding the imaging findings until understanding the surgical technique operations were done by. Many complications can be seen by fluoroscopy and computed tomography with the fluoroscopic examination being superior in early post-operative cases as a dynamic technique helping visualization of the new post-operative anatomy. Early, intermediate and delayed GIT/Extra GIT complications were seen. CT played a major role in post-operative evaluation of symptomatic patients with negative fluoroscopic exam. CT also showed a great new role in the evaluation of the size of the new post-operative stomach/pouch by 3D tissue volumetry as an important step before any revisonal surgery and as a follow up in non-responding patients to the treatment in order to differentiate anatomical abnormality from bad behavioral attitude. We found that with well hand skilled surgeon good results and no major complications seen. Old operations done 5 to 10 years back ago represented a challenge for us during examination and evaluation, owing to the absence of the detailed surgical technique and difficulty in recognizing the new anatomy. Many patients were seen with successful operations but still no weight loss was achieved likely due to their bad behavioral attitude therefor Summary and conclusion 256 needed more educational therapy than revisional surgeries. CT and 3D CT allow for comprehensive and quantitative evaluation of the anatomy after sleeve gastrectomy and so provide new insights in the process of sleeve dilatation. Finally, imaging methods by fluoroscopy and CT played a significant role in the postoperative evaluation of bariatric surgery both to detect a normal post-operative anatomy and to diagnose post-operative complications.