Role of pre and post oral and IV contrast MDCT scan of the abdomen in assessment of early complications after laparoscopic sleeve gastrectomy (LSG)

Abstract

BackgroundLaparoscopic sleeve gastrectomy (LSG) is a commonly performed bariatric surgical procedure. Abdominal CT scan is a preferred useful modality in detection of early post sleeve gastrectomy complications, namely staple line leakage, bleeding, mesenteric vascular thrombosis and splenic infarction. The aim of our study is to assess the value of abdominal MDCT in diagnosis of suspected early complications following laparoscopic sleeve gastrectomy operations.MethodsData collection included clinical and laboratory data from the referral requests written by the surgeons. MDCT scan then was performed for all patients. Follow-up clinical data for all patients and follow-up surgical findings for some patients who needed surgical intervention were collected and correlated with the CT findings.ResultsThis prospective study included 75 patients referred by their surgeons as clinically suspected to have acute post LSG complications. MDCT scan was done for all those patients and detected multiple post-operative complications in 68 patients (91%) with the most common one was staple line gastric leak in 30 patients (40%), other complications were also detected as intra-abdominal abscess, porto-mesenteric thrombosis, splenic infarction and pulmonary complications. CT findings were correlated with the clinical, surgical and laboratory data of the patients as well as the follow-up findings.ConclusionsMDCT scan is a reliable imaging modality for detecting acute post LSG complications and correlates well with both the clinical presentation and patient's follow-up data.