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Computed Tomography Assessment of Gastric Band Slippage

BACKGROUND: The purpose of this study was to develop and validate reliable computed tomography (CT) imaging criteria for the diagnosis of gastric band slippage. MATERIAL AND METHODS: We retrospectively evaluated 67 patients for gastric band slippage using CT. Of these, 14 had surgically proven gastr...

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Autores principales: Burt, Jeremy R., Kocher, Madison R., Snider, Lauren, Waltz, Jeffrey, Chamberlin, Jordan Heston, Aquino, Gilberto J., Giovagnoli, Vincent, Mercer, Megan, Feranec, Nicholas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: S. Karger AG 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9421695/
https://www.ncbi.nlm.nih.gov/pubmed/36160820
http://dx.doi.org/10.1159/000524588
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author Burt, Jeremy R.
Kocher, Madison R.
Snider, Lauren
Waltz, Jeffrey
Chamberlin, Jordan Heston
Aquino, Gilberto J.
Giovagnoli, Vincent
Mercer, Megan
Feranec, Nicholas
author_facet Burt, Jeremy R.
Kocher, Madison R.
Snider, Lauren
Waltz, Jeffrey
Chamberlin, Jordan Heston
Aquino, Gilberto J.
Giovagnoli, Vincent
Mercer, Megan
Feranec, Nicholas
author_sort Burt, Jeremy R.
collection PubMed
description BACKGROUND: The purpose of this study was to develop and validate reliable computed tomography (CT) imaging criteria for the diagnosis of gastric band slippage. MATERIAL AND METHODS: We retrospectively evaluated 67 patients for gastric band slippage using CT. Of these, 14 had surgically proven gastric band slippage (study group), 22 had their gastric bands removed for reasons other than slippage (control group 1), and 31 did not require removal (control group 2). All of the studies were read independently by two radiologists in a blinded fashion. The “O” sign, phi angle, amount of inferior displacement from the esophageal hiatus, and gastric pouch size were used to create CT diagnostic criteria. Standard statistical methods were used. RESULTS: There was good overall interobserver agreement for diagnosis of gastric band slippage using CT diagnostic criteria (kappa = 0.83). Agreement was excellent for the “O” sign (kappa = 0.93) and phi angle (intraclass correlation coefficient = 0.976). The “O” sign, inferior displacement from the hiatus >3.5 cm, and gastric pouch volume >55 cm(3) each had 100% positive predictive value. A phi angle <20° or >60° had the highest negative predictive value (NPV) (98%). Of all CT diagnostic criteria, enlarged gastric pouch size was most correlated with band slippage with an AUC of 0.991. CONCLUSION: All four imaging parameters were useful in evaluating for gastric band slippage on CT, with good interobserver agreement. Of these parameters, enlarged gastric pouch size was most correlated with slippage and abnormal phi angle had the highest NPV.
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spelling pubmed-94216952022-09-23 Computed Tomography Assessment of Gastric Band Slippage Burt, Jeremy R. Kocher, Madison R. Snider, Lauren Waltz, Jeffrey Chamberlin, Jordan Heston Aquino, Gilberto J. Giovagnoli, Vincent Mercer, Megan Feranec, Nicholas Visc Med Research Article BACKGROUND: The purpose of this study was to develop and validate reliable computed tomography (CT) imaging criteria for the diagnosis of gastric band slippage. MATERIAL AND METHODS: We retrospectively evaluated 67 patients for gastric band slippage using CT. Of these, 14 had surgically proven gastric band slippage (study group), 22 had their gastric bands removed for reasons other than slippage (control group 1), and 31 did not require removal (control group 2). All of the studies were read independently by two radiologists in a blinded fashion. The “O” sign, phi angle, amount of inferior displacement from the esophageal hiatus, and gastric pouch size were used to create CT diagnostic criteria. Standard statistical methods were used. RESULTS: There was good overall interobserver agreement for diagnosis of gastric band slippage using CT diagnostic criteria (kappa = 0.83). Agreement was excellent for the “O” sign (kappa = 0.93) and phi angle (intraclass correlation coefficient = 0.976). The “O” sign, inferior displacement from the hiatus >3.5 cm, and gastric pouch volume >55 cm(3) each had 100% positive predictive value. A phi angle <20° or >60° had the highest negative predictive value (NPV) (98%). Of all CT diagnostic criteria, enlarged gastric pouch size was most correlated with band slippage with an AUC of 0.991. CONCLUSION: All four imaging parameters were useful in evaluating for gastric band slippage on CT, with good interobserver agreement. Of these parameters, enlarged gastric pouch size was most correlated with slippage and abnormal phi angle had the highest NPV. S. Karger AG 2022-08 2022-05-06 /pmc/articles/PMC9421695/ /pubmed/36160820 http://dx.doi.org/10.1159/000524588 Text en Copyright © 2022 by The Author(s). Published by S. Karger AG, Basel https://creativecommons.org/licenses/by-nc/4.0/This article is licensed under the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC). Usage and distribution for commercial purposes requires written permission. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
spellingShingle Research Article
Burt, Jeremy R.
Kocher, Madison R.
Snider, Lauren
Waltz, Jeffrey
Chamberlin, Jordan Heston
Aquino, Gilberto J.
Giovagnoli, Vincent
Mercer, Megan
Feranec, Nicholas
Computed Tomography Assessment of Gastric Band Slippage
title Computed Tomography Assessment of Gastric Band Slippage
title_full Computed Tomography Assessment of Gastric Band Slippage
title_fullStr Computed Tomography Assessment of Gastric Band Slippage
title_full_unstemmed Computed Tomography Assessment of Gastric Band Slippage
title_short Computed Tomography Assessment of Gastric Band Slippage
title_sort computed tomography assessment of gastric band slippage
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9421695/
https://www.ncbi.nlm.nih.gov/pubmed/36160820
http://dx.doi.org/10.1159/000524588
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