TY - JOUR
T1 - Percutaneous computed tomography-guided gastric remnant access after laparoscopic Roux-en-Y gastric bypass
AU - Goitein, David
AU - Gagné, Daniel J.
AU - Papasavas, Pavlos K.
AU - McLean, Gordon
AU - Foster, Richard G.
AU - Beasley, H. Scott
AU - Caushaj, Philip F.
N1 - Funding Information:
Supported in part by a research grant from Tyco/United States Surgical Corporation
PY - 2006/11
Y1 - 2006/11
N2 - Background: The bypassed portion of the stomach is difficult to access and evaluate after Roux-en-Y gastric bypass. Access to the excluded stomach may be needed for nutritional support or decompression owing to acute distension and obstruction. We report our experience with percutaneous, computed tomography (CT)-guided gastrostomy tube placement into the gastric remnant after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods: Of 569 consecutive LRYGB procedures performed, 9 patients underwent successful percutaneous, CT-guided gastrostomy placement. One additional patient was referred from another facility. We reviewed the indications, interval from surgery to the intervention, interval to removal, complications, and success or outcome of the procedure in our patient population. Results: Ten patients underwent percutaneous, CT-guided gastric remnant gastrostomy tube placement. The indications included distended gastric remnant in 6, nutritional access in 4, and remnant drainage after leak in 1. Of the 10 patients, 2 had undergone previous gastric operations. The attempt at percutaneous gastrostomy was unsuccessful in 1 additional patient, who subsequently required laparoscopic gastrostomy (success rate 91%). Conclusion: In selected patients after LRYGB, CT-guided gastrostomy tube placement is safe and efficient. It may be used to manage complications of LRYGB, serve as a bridge to definitive surgery, or offer a convenient route for enteral nutritional support.
AB - Background: The bypassed portion of the stomach is difficult to access and evaluate after Roux-en-Y gastric bypass. Access to the excluded stomach may be needed for nutritional support or decompression owing to acute distension and obstruction. We report our experience with percutaneous, computed tomography (CT)-guided gastrostomy tube placement into the gastric remnant after laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods: Of 569 consecutive LRYGB procedures performed, 9 patients underwent successful percutaneous, CT-guided gastrostomy placement. One additional patient was referred from another facility. We reviewed the indications, interval from surgery to the intervention, interval to removal, complications, and success or outcome of the procedure in our patient population. Results: Ten patients underwent percutaneous, CT-guided gastric remnant gastrostomy tube placement. The indications included distended gastric remnant in 6, nutritional access in 4, and remnant drainage after leak in 1. Of the 10 patients, 2 had undergone previous gastric operations. The attempt at percutaneous gastrostomy was unsuccessful in 1 additional patient, who subsequently required laparoscopic gastrostomy (success rate 91%). Conclusion: In selected patients after LRYGB, CT-guided gastrostomy tube placement is safe and efficient. It may be used to manage complications of LRYGB, serve as a bridge to definitive surgery, or offer a convenient route for enteral nutritional support.
KW - Bowel obstruction
KW - Complications
KW - CT guidance
KW - Gastric bypass
KW - Gastrostomy
KW - Percutaneous
UR - http://www.scopus.com/inward/record.url?scp=33751311047&partnerID=8YFLogxK
U2 - 10.1016/j.soard.2006.09.007
DO - 10.1016/j.soard.2006.09.007
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C2 - 17138237
AN - SCOPUS:33751311047
VL - 2
SP - 651
EP - 655
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
SN - 1550-7289
IS - 6
ER -