CT Fluoroscopy-Guided Drain Placement to Treat Infected Gastric Leakage after Sleeve Gastrectomy: Technical and Clinical Outcome of 31 Procedures

Schwarz, Jens; Strobl, Frederik Franz; Paprottka, Philipp M.; D'Anastasi, Melvin; Spelsberg, Fritz W.; Rentsch, Markus; Reiser, Maximilian und Trumm, Christoph Gregor (2020): CT Fluoroscopy-Guided Drain Placement to Treat Infected Gastric Leakage after Sleeve Gastrectomy: Technical and Clinical Outcome of 31 Procedures. In: Rofo-Fortschritte Auf Dem Gebiet der Rontgenstrahlen und der Bildgebenden Verfahren, Bd. 192, Nr. 2: S. 163-170

Abstract

Purpose: To observe the technical and clinical outcome as well as safety of CT fluoroscopy-guided drain placement in the multimodal clinical complication management of superinfected gastric leakage after sleeve gastrectomy. Materials and Methods All consecutive patients who underwent CT fluoroscopy-guided drain placement to treat superinfected postoperative leakage after sleeve gastrectomy in our department between 2007 and 2014 were included in this retrospective study. All interventions were performed on a 16- or 128-row CT scanner under intermittent CT fluoroscopy guidance (15-25mAs, 120 kV). The technical and clinical success rates as well as complications, additional therapies and patient radiation dose were analyzed. Results: 14 patients (mean age: 43.8 +/- 11.3 years, mean BMI: 52.9 +/- 13.5, 7 women) who underwent a total of 31 CT fluoroscopy-guided drain placement procedures were included. 30 of 31 interventions ( 96.8 %) were technically successful. 7 patients underwent more than one intervention due to drain obstruction or secondary dislocation or as further treatment. During and after the intervention no procedure-associated complications occurred. In all patients, inflammation parameters decreased within days after the CT-guided intervention. The total interventional dose length product (DLP) was 1561 +/- 1035 mGy*cm. Conclusion CT fluoroscopy-guided drain placement has been shown to be a safe minimally invasive procedure that rarely leads to complications for treating superinfected gastric leakage occurring after sleeve gastrectomy. We assume that operative revisions in a high-risk patient group can be avoided using this procedure.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1438-9029
• Sprache: Englisch