Laparoscopic adjustable silicone gastric banding leakage assessed by Tc-99m-pertechnetate scintigraphy

The purpose of this study was to assess the value of Tc-99m-pertechnetate s canning in the diagnosis of gastric banding leaks. Methods: Three patients with morbid obesity received laparoscopic adjustable silicone gastric bandi ng (ASGB), but no significant weight reduction was obtained. To exclude ban d leakage as the cause, four scintigraphic procedures were performed, consi sting of imaging the upper abdomen 30 min and 3 h after injection of 3 mt ( 111 MBq) pertechnetate solution into the ASGB reservoir. In one patient, th e integrity of the ASGB device: was first assessed radiologically after inj ection of a water-soluble contrast agent into the ASGB reservoir. Results: In two normally functioning ASGB devices, radiotracer was observed within t he device on both early and late images. In two patients with a surgically proven small leak in the reservoir or the connecting tube, late images show ed little tracer in the reservoir and the connecting tube. However, intense tracer accumulation was observed in the stomach as a result of resorption of pertechnetate in the subcutaneous or peritoneal blood vessels and subseq uent gastric uptake. In one of the latter patients, radiographic assessment of the ASGB device revealed no abnormalities. Conclusion: Tc-99m-pertechne tate scanning is a valuable technique to diagnose small leaks in an ASGB de vice.