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Abdominal Radiology

, Volume 37, Issue 5, pp 697–711 | Cite as

Imaging following bariatric procedures: Roux-en-Y gastric bypass, gastric sleeve, and biliopancreatic diversion

  • Laura R. CarucciEmail author
  • Mary Ann Turner
Article

Abstract

Morbid obesity remains as a common and increasing health problem. Due to limited long-term success with nonsurgical weight loss measures for morbid obesity, bariatric surgery is being performed more and more often in both academic and private practice settings and has proven to be an effective treatment option with sustained weight loss, decreased morbidity, reversal of comorbidities, and prolonged life expectancies [Am J Clin Nutr 55:615S–619S, 1992; Brolin, Nutrition 12:403–404, 1996; Fisher and Schauer, Am J Surg 184:9S–16S 2002]. The Roux-en-Y gastric bypass, biliopancreatic diversion, and gastric sleeve will be discussed in terms of their expected imaging appearance and potential complications.

Keywords

Roux-en-Y gastric bypass Biliopancreatic diversion Sleeve gastrectomy Bariatric surgery 

References

  1. 1.
    Gastrointestinal surgery for severe obesity: National Institutes of Health Consensus Development Conference Statement (1992) Am J Clin Nutr 55:615S–619S.Google Scholar
  2. 2.
    Brolin RE (1996) Update: NIH consensus conference. Gastrointestinal surgery for severe obesity. Nutrition 12:403–404CrossRefPubMedGoogle Scholar
  3. 3.
    Fisher BL, Schauer P (2002) Medical and surgical options in the treatment of severe obesity. Am J Surg 184:9S–16SCrossRefPubMedGoogle Scholar
  4. 4.
    DeMaria EJ, Sugerman HJ, Kellum JM, Meador JG, Wolfe LG (2002) Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg 235:640–645 (discussion 645–647)CrossRefPubMedPubMedCentralGoogle Scholar
  5. 5.
    Higa KD, Boone KB, Ho T (2000) Complications of the laparoscopic Roux-en-Y gastric bypass: 1,040 patients—what have we learned? Obes Surg 10:509–513CrossRefPubMedGoogle Scholar
  6. 6.
    Schauer PR, Ikramuddin S, Gourash W, Ramanathan R, Luketich J (2000) Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 232:515–529CrossRefPubMedPubMedCentralGoogle Scholar
  7. 7.
    Sugerman HJ (2002) Gastric bypass surgery for severe obesity. Semin Laparosc Surg 9:79–85CrossRefPubMedGoogle Scholar
  8. 8.
    Chandler RC, Srinivas G, Chintapalli KN, Schwesinger WH, Prasad SR (2008) Imaging in bariatric surgery: a guide to postsurgical anatomy and common complications. AJR Am J Roentgenol 190:122–135CrossRefPubMedGoogle Scholar
  9. 9.
    Santry HP, Gillen DL, Lauderdale DS (2005) Trends in bariatric surgical procedures. JAMA 294:1909–1917CrossRefPubMedGoogle Scholar
  10. 10.
    Carucci LR, Turner MA, Conklin RC, et al. (2006) Roux-en-Y gastric bypass surgery for morbid obesity: evaluation of postoperative extraluminal leaks with upper gastrointestinal series. Radiology 238:119–127CrossRefPubMedGoogle Scholar
  11. 11.
    Buckwalter JA, Herbst CA Jr (1988) Leaks occurring after gastric bariatric operations. Surgery 103:156–160PubMedGoogle Scholar
  12. 12.
    Fobi MA, Lee H, Holness R, Cabinda D (1998) Gastric bypass operation for obesity. World J Surg 22:925–935CrossRefPubMedGoogle Scholar
  13. 13.
    Carucci LR, Turner MA, Yu J (2007) Imaging evaluation following Roux-en-Y gastric bypass surgery for morbid obesity. Radiol Clin North Am 45:247–260CrossRefPubMedGoogle Scholar
  14. 14.
    Goodman P, Halpert RD (1991) Radiological evaluation of gastric stapling procedures for morbid obesity. Crit Rev Diagn Imaging 32:37–67PubMedGoogle Scholar
  15. 15.
    Buckwalter JA, Herbst CA Jr (1980) Complications of gastric bypass for morbid obesity. Am J Surg 139:55–60CrossRefPubMedGoogle Scholar
  16. 16.
    Carucci LR, Conklin RC, Turner MA (2008) Roux-en-Y gastric bypass surgery for morbid obesity: evaluation of leak into excluded stomach with upper gastrointestinal examination. Radiology 248:504–510CrossRefPubMedGoogle Scholar
  17. 17.
    Blachar A, Federle MP (2002) Gastrointestinal complications of laparoscopic Roux-en-Y gastric bypass surgery in patients who are morbidly obese: findings on radiography and CT. AJR Am J Roentgenol 179:1437–1442CrossRefPubMedGoogle Scholar
  18. 18.
    Blachar A, Federle MP, Pealer KM, Ikramuddin S, Schauer PR (2002) Gastrointestinal complications of laparoscopic Roux-en-Y gastric bypass surgery: clinical and imaging findings. Radiology 223:625–632CrossRefPubMedGoogle Scholar
  19. 19.
    Champion JK, Williams M (2003) Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass. Obes Surg 13:596–600CrossRefPubMedGoogle Scholar
  20. 20.
    Filip JE, Mattar SG, Bowers SP, Smith CD (2002) Internal hernia formation after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Am Surg 68:640–643PubMedGoogle Scholar
  21. 21.
    Higa KD, Ho T, Boone KB (2003) Internal hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment and prevention. Obes Surg 13:350–354CrossRefPubMedGoogle Scholar
  22. 22.
    Iannelli A, Buratti MS, Novellas S, et al. (2007) Internal hernia as a complication of laparoscopic Roux-en-Y gastric bypass. Obes Surg 17:1283–1286CrossRefPubMedGoogle Scholar
  23. 23.
    Sunnapwar A, Sandrasegaran K, Menias CO, et al. (2010) Taxonomy and imaging spectrum of small bowel obstruction after Roux-en-Y gastric bypass surgery. AJR Am J Roentgenol 194:120–128CrossRefPubMedGoogle Scholar
  24. 24.
    Tucker ON, Escalante-Tattersfield T, Szomstein S, Rosenthal RJ (2007) The ABC System: a simplified classification system for small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Obes Surg 17:1549–1554CrossRefPubMedGoogle Scholar
  25. 25.
    Carucci LR, Turner MA, Shaylor SD (2009) Internal hernia following Roux-en-Y gastric bypass surgery for morbid obesity: evaluation of radiographic findings at small-bowel examination. Radiology 251:762–770CrossRefPubMedGoogle Scholar
  26. 26.
    Blachar A, Federle MP, Dodson SF (2001) Internal hernia: clinical and imaging findings in 17 patients with emphasis on CT criteria. Radiology 218:68–74CrossRefPubMedGoogle Scholar
  27. 27.
    Lockhart ME, Tessler FN, Canon CL, et al. (2007) Internal hernia after gastric bypass: sensitivity and specificity of seven CT signs with surgical correlation and controls. AJR Am J Roentgenol 188:745–75040CrossRefPubMedGoogle Scholar
  28. 28.
    Reddy SA, Yang C, McGinnis LA, et al. (2007) Diagnosis of transmesocolic internal hernia as a complication of retrocolic gastric bypass: CT imaging criteria. AJR Am J Roentgenol 189:52–55CrossRefPubMedGoogle Scholar
  29. 29.
    Rosen DJ, Dakin GF, Pomp A (2009) Sleeve gastrectomy. Minerva Chir 64:285–295PubMedGoogle Scholar
  30. 30.
    Abu-Jaish W, Rosenthal RJ (2010) Sleeve gastrectomy: a new surgical approach to morbid obesity. Review. Gastroenterol Hepatol 4:101–119Google Scholar
  31. 31.
    Gluck B, Movitz B, Jansma S, Gluck J, Laskowski K (2010) Laparoscopic sleeve gastrectomy is a safe and effective bariatric procedure for the lower BMI (35–43 kg/m2) population. Obes Surg 21:1168–1171CrossRefPubMedCentralGoogle Scholar
  32. 32.
    Basso N, Casella G, Rizzello M, et al. (2011) Laparoscopic gastric sleeve as first stage or definitive intent in 300 consecutive cases. Surg Endosc 25:444–449CrossRefPubMedGoogle Scholar
  33. 33.
    Goitein D, Goitein O, Feigin A, Zippel D, Papa M (2009) Sleeve gastrectomy: radiological patterns after surgery. Surg Endosc 23:1559–1563CrossRefPubMedGoogle Scholar
  34. 34.
    Jurowich C, Thalheimer A, Seyfried F, et al. (2011) Gastric leakage after sleeve gastrectomy-clinical presentation and therapeutic options. Arch Surg 396:981–987CrossRefGoogle Scholar
  35. 35.
    Stamou KM, Menenokos E, Gomatos IP, et al. (2010) Clinical implications of sleeve gastrectomy as a source of splenic infarction or ischemia. Obes Surg 21:1490–1493CrossRefGoogle Scholar
  36. 36.
    Hess DS, Hess DW (1998) Biliopancreatic diversion with a duodenal switch. Obes Surg 8:267–282CrossRefPubMedGoogle Scholar
  37. 37.
    Topart P, Becouarn G, Salle A (2011) Five-year follow-up after biliopancreatic diversion with duodenal switch. Surg Obes Relat Dis 7:199–205CrossRefPubMedGoogle Scholar
  38. 38.
    Crea N, Pata G, DiBetta E, et al. (2011) Long-term results of biliopancreatic diversion with or without gastric preservation for morbid obesity. Obes Surg 21:139–145CrossRefPubMedGoogle Scholar
  39. 39.
    Prachand VN, DaVee RT, Alverdy JC (2006) Duodenal switch provides superior weight loss in the superobese (BMI > 50 kg/m2) compared with gastric bypass. Ann Surg 244:611–619PubMedPubMedCentralGoogle Scholar
  40. 40.
    Mitchell MT, Carabetta JM, Shah RN, et al. (2009) Duodenal switch gastric bypass surgery for morbid obesity: imaging of postsurgical anatomy and postoperative gastrointestinal complications. AJR Am J Roentgenol 193:1576–1580CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Virginia Commonwealth University Health SystemRichmondUSA

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