Purpose: Laparoscopic adjustable gastric banding (LAGB) is one of the least invasive bariatric operations. The surgeon places a band around the upper part of the stomach to create a small pouch resulting in early satiety. To the best of our knowledge there are no previous series summarizing the spectrum of complications after LAGB as seen on CT examinations.
The aim of this study is to present the spectrum of CT findings of LAGB complications.
Methods: A computerized retrospective search for the term "gastric banding" in CT interpretations was performed in our institution`s radiological information system (RIS) (12/2011 – 4/2017) to identify patients who underwent CT examinations after LAGB. The clinical indications for CTs were retrieved. CT scans were reviewed to identify findings suggestive of complications resulting from gastric- banding. The CT findings were divided into two groups: 1. symptomatic group in which the complication caused the symptoms and 2. complications were an incidental finding. The type of complications incidence in each group was calculated.
Results: 160 patients (M:F 48:112) who underwent CT after LAGB, with an average age of 51±12 years were retrieved. Overall, 85 findings suggestive of complications were identified in 69/160 (43.1%) patients. Examinations included 99 abdominal, 34 chest-abdomen, 25 chest and 2 spinal CT scans. When compared with the referral note, 30/85 (34.1%) of the complications caused symptoms and were the indication for the exam, whereas 56/85 (65.9%) were incidental findings. In the symptomatic group findings included: pulmonary, 10/30 (33.3%) (4 pulmonary abscesses, 4 consolidations, 2 empyema); abdominal abscess, 6/30 (20%), small bowel obstruction, 5/30 (16.7%); intragastric band erosion, and port site infection 3/30 (10.0%) each. Ring slippage, esophageal bezoar, strangulated hiatal hernia all had an incidence of 1/30 (3.3%). In the incidental group findings were: esophageal dilation, 46/55 (83.6%); tube disconnection, 4/55 (7.2%); pulmonary consolidation 3/55 (5.4%); intrasgastric band erosion and nasogastric tube coiling in the esophagus, 1/55 (1.8%) each.
Conclusions: Complications were found in 43% of CT scans of patients after LAGB. One third of the complications were symptomatic and the rest were incidentally identified. The most common symptomatic complications were pulmonary complications, abdominal abscess and small bowel obstruction. Incidental finding were mostly benign and mainly esophageal dilation, yet some had significant clinical importance.
