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Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications

Laparoscopic sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. The primary and insidious early post-SG complication is the gastric leak (GL). In literature, there are many studies describing the endoscopic stent placement as treatment of GL and few studies about stent place...

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Autores principales: Scavone, Giovanni, Caltabiano, Giuseppe, Inì, Corrado, Castelli, Federica, Falsaperla, Daniele, Basile, Antonio, Piazza, Luigi, Scavone, Antonio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elsevier 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8810407/
https://www.ncbi.nlm.nih.gov/pubmed/35141438
http://dx.doi.org/10.1016/j.heliyon.2022.e08857
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author Scavone, Giovanni
Caltabiano, Giuseppe
Inì, Corrado
Castelli, Federica
Falsaperla, Daniele
Basile, Antonio
Piazza, Luigi
Scavone, Antonio
author_facet Scavone, Giovanni
Caltabiano, Giuseppe
Inì, Corrado
Castelli, Federica
Falsaperla, Daniele
Basile, Antonio
Piazza, Luigi
Scavone, Antonio
author_sort Scavone, Giovanni
collection PubMed
description Laparoscopic sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. The primary and insidious early post-SG complication is the gastric leak (GL). In literature, there are many studies describing the endoscopic stent placement as treatment of GL and few studies about stent placement performed by interventional radiology under fluoroscopic guide. Our aims were to describe the radiological stent placement technique, to compare endoscopic and radiological stent placement, to illustrate normal diagnostic features and summarise the incidence of complications after stent placement, removal, and their imaging features. This was a single centre retrospective study of 595 patients who underwent SG between 2011 and 2019. Inclusion criteria: patients who developed GL after SG and treated with gastro-oesophageal stent placement by endoscopy or interventional radiology; availability of medical history and imaging studies; follow-up time after stent removal (1 year). The rates of technical success, clinical success and complications after stent placement and removal were collected and compared between the two methods of stent positioning. A total of 17/595 (2.8%) patients developed a radiologically diagnosed GL after SG. The type II-III GLs (15/17) were treated with endoscopic or radiological stent placement. 9/15 (60%/Group A) patients underwent gastro-oesophageal stenting by interventional radiology and 6/15 (40%/Group B) were treated with endoscopic stent placement. The technical and clinical success rate was 100% for both groups. Stent migration occurred in 22% and 27% for Group A and B respectively. Post-extraction stenosis was the main late complication, occurring in 22% in Group A and 0% in Group B. Gastro-esophageal stent placement performed by interventional radiologists is a valid “mini-invasive” treatment for GL. This procedure is not inferior to endoscopic positioning regarding efficacy, periprocedural and postprocedural complication rate. It's necessary to be familiar with radiological findings after stent placement and removal. Computed tomography (CT) scan is the main radiological technique to identify stent placement complications. Upper gastrointestinal (UGI) series are the first radiological procedures used to detect late complications after stent removal.
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spelling pubmed-88104072022-02-08 Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications Scavone, Giovanni Caltabiano, Giuseppe Inì, Corrado Castelli, Federica Falsaperla, Daniele Basile, Antonio Piazza, Luigi Scavone, Antonio Heliyon Research Article Laparoscopic sleeve gastrectomy (SG) is the most commonly performed bariatric procedure. The primary and insidious early post-SG complication is the gastric leak (GL). In literature, there are many studies describing the endoscopic stent placement as treatment of GL and few studies about stent placement performed by interventional radiology under fluoroscopic guide. Our aims were to describe the radiological stent placement technique, to compare endoscopic and radiological stent placement, to illustrate normal diagnostic features and summarise the incidence of complications after stent placement, removal, and their imaging features. This was a single centre retrospective study of 595 patients who underwent SG between 2011 and 2019. Inclusion criteria: patients who developed GL after SG and treated with gastro-oesophageal stent placement by endoscopy or interventional radiology; availability of medical history and imaging studies; follow-up time after stent removal (1 year). The rates of technical success, clinical success and complications after stent placement and removal were collected and compared between the two methods of stent positioning. A total of 17/595 (2.8%) patients developed a radiologically diagnosed GL after SG. The type II-III GLs (15/17) were treated with endoscopic or radiological stent placement. 9/15 (60%/Group A) patients underwent gastro-oesophageal stenting by interventional radiology and 6/15 (40%/Group B) were treated with endoscopic stent placement. The technical and clinical success rate was 100% for both groups. Stent migration occurred in 22% and 27% for Group A and B respectively. Post-extraction stenosis was the main late complication, occurring in 22% in Group A and 0% in Group B. Gastro-esophageal stent placement performed by interventional radiologists is a valid “mini-invasive” treatment for GL. This procedure is not inferior to endoscopic positioning regarding efficacy, periprocedural and postprocedural complication rate. It's necessary to be familiar with radiological findings after stent placement and removal. Computed tomography (CT) scan is the main radiological technique to identify stent placement complications. Upper gastrointestinal (UGI) series are the first radiological procedures used to detect late complications after stent removal. Elsevier 2022-01-28 /pmc/articles/PMC8810407/ /pubmed/35141438 http://dx.doi.org/10.1016/j.heliyon.2022.e08857 Text en © 2022 The Author(s) https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Research Article
Scavone, Giovanni
Caltabiano, Giuseppe
Inì, Corrado
Castelli, Federica
Falsaperla, Daniele
Basile, Antonio
Piazza, Luigi
Scavone, Antonio
Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications
title Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications
title_full Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications
title_fullStr Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications
title_full_unstemmed Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications
title_short Radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications
title_sort radiological stent placement of post sleeve gastrectomy leak: efficacy, imaging features and post-procedure complications
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8810407/
https://www.ncbi.nlm.nih.gov/pubmed/35141438
http://dx.doi.org/10.1016/j.heliyon.2022.e08857
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