The Swedish laparoscopic adjustable gastric banding for morbid obesity: Radiologic findings in 218 patients

Objective. The objective of this study was to determine the prevalence and radiologic features of postoperative complications after Swedish laparoscop ic adjustable gastric banding surgery and to emphasize the role of the radi ologist in the follow-up of those patients, especially in the treatment of complications. Materials and methods. We reviewed the radiologic findings in 218 consecuti ve morbidly obese patients after laparoscopic placement of the Swedish gast ric banding system. Radiographic studies of the stomach (obtained with liqu id barium sulfate suspension) were performed before surgery and 1 month aft er band placement in every patient. Additional studies in symptomatic patie nts were performed when needed. Results. Surgical complications found included misplacement of the band (fi ve patients, 2.3%), slippage of the band (17 patients, 7.8%), and pouch enl argement (eight patients, 3.7%). Technical problems encountered were invers ion of the access port (three patients, 1.4%), leakage of the device (two p atients, 0.9%), and spontaneous decrease of the stoma size caused by gastri tis (seven patients, 3.2%) or the hyperosmolar properties of the IV contras t material (12 patients, 5.5%). Intrinsic abnormalities of gastroesophageal tract seen included trapping of food in the stoma (four patients, 1.8%) an d esophagitis (11 patients, 5%). Conclusion. Although, according to the available data, the gastric banding operation with the Swedish band meets the criteria of a low-risk laparoscop ic alternative treatment of morbid obesity, the radiologic appearances of v arious complications may be seen on the images of patients who have undergo ne the procedure. The radiologist plays a key role in the early detection o f those complications and treatment of specific abnormalities.