Radiological evaluation of the vertical banded gastroplasty for morbid obesity

Abstract

Vertical banded gastroplasty (VBG) was performed in 70 morbidly obese patients between September 1988 and February 1991. All patients underwent a routine abdominal ultrasonographic (US) ctudy preoperatively, an upper gastrointestinal (GI) contrast study on the fifth day after VBG, and US and upper GI studies at 6, 12, 18 and 24 months postoperatively. The main abnormalities detected included staple-line distuption (22.85%), extragastric leak (2.85%), outlet obstruction (7.14%), gallstones (37.14%) and fatty liver (75.50 %). Asymptomatic cholelithiasis following VBG was detected by US in 25.8% of cases. Hepatic US follow-up showed the echographic pattern had returned to normal in 47.61% of cases. The 100% sensitivity and 100% specificity of gallstone detection at pre-VBG study in this series further confirms the role of US in the evaluation of cholithiasis, even in the morbidly abese. The 88.67% sensitivity and 100% specificity of fatty liver detection by US is similar to results from other studies. We suggest US and upper GI studies should be carried out routinely in morbidly obese patients not only for early detection of postsurgical complications but also to evaluate cholelithiasis and hepatic parenchyma following VBG.