Korean Journal of Radiology

The Korean Society of Radiology (대한영상의학회)
권호 표지
DOI QR코드

DOI QR Code

Mini-Gastric Bypass to Control Morbid Obesity and Diabetes Mellitus: What Radiologists Need to Know

  • Park, Hyun Jeong (Department of Radiology, Chung-Ang University Hospital) ;
  • Hong, Seong Sook (Department of Radiology, Soonchunhyang University Seoul Hospital) ;
  • Hwang, Jiyoung (Department of Radiology, Soonchunhyang University Seoul Hospital) ;
  • Hur, Kyung Yul (Department of Surgery, Soonchunhyang University Seoul Hospital)
  • Received : 2014.06.11
  • Accepted : 2015.01.07
  • Published : 2015.04.01
⟨ Previous Next ⟩

Abstract

Laparoscopic mini-gastric bypass surgery is a safe and simple surgical intervention for treating morbid obesity and diabetes mellitus and is now being performed more frequently. Radiologists must be critical in their postoperative evaluation of these patients. In this pictorial review, we explain and illustrate the surgical technique, normal postoperative anatomy, and associated complications as seen on imaging examinations, including fluoroscopy and computed tomography.

Keywords

References

  1. NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med 1991;115:956-961 https://doi.org/10.7326/0003-4819-115-12-956
  2. Pories WJ, Swanson MS, MacDonald KG, Long SB, Morris PG, Brown BM, et al. Who would have thought it? An operation proves to be the most effective therapy for adult-onset diabetes mellitus. Ann Surg 1995;222:339-350; discussion 350-352 https://doi.org/10.1097/00000658-199509000-00011
  3. O'Brien PE, Dixon JB, Laurie C, Skinner S, Proietto J, McNeil J, et al. Treatment of mild to moderate obesity with laparoscopic adjustable gastric banding or an intensive medical program: a randomized trial. Ann Intern Med 2006;144:625-633 https://doi.org/10.7326/0003-4819-144-9-200605020-00005
  4. Adams TD, Gress RE, Smith SC, Halverson RC, Simper SC, Rosamond WD, et al. Long-term mortality after gastric bypass surgery. N Engl J Med 2007;357:753-761 https://doi.org/10.1056/NEJMoa066603
  5. Schauer PR, Burguera B, Ikramuddin S, Cottam D, Gourash W, Hamad G, et al. Effect of laparoscopic Roux-en Y gastric bypass on type 2 diabetes mellitus. Ann Surg 2003;238:467-484; discussion 484-485
  6. Lee WJ, Wang W, Lee YC, Huang MT, Ser KH, Chen JC. Effect of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: comparison of BMI>35 and <35 kg/m2. J Gastrointest Surg 2008;12:945-952 https://doi.org/10.1007/s11605-007-0319-4
  7. Brethauer SA, Aminian A, Romero-Talamas H, Batayyah E, Mackey J, Kennedy L, et al. Can diabetes be surgically cured? Long-term metabolic effects of bariatric surgery in obese patients with type 2 diabetes mellitus. Ann Surg 2013;258:628-636; discussion 636-637
  8. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, et al. Bariatric surgery versus intensive medical therapy for diabetes--3-year outcomes. N Engl J Med 2014;370:2002-2013 https://doi.org/10.1056/NEJMoa1401329
  9. Lee WJ, Yu PJ, Wang W, Chen TC, Wei PL, Huang MT. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg 2005;242:20-28 https://doi.org/10.1097/01.sla.0000167762.46568.98
  10. Lee WJ, Ser KH, Lee YC, Tsou JJ, Chen SC, Chen JC. Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg 2012;22:1827-1834 https://doi.org/10.1007/s11695-012-0726-9
  11. Musella M, Susa A, Greco F, De Luca M, Manno E, Di Stefano C, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc 2014;28:156-163 https://doi.org/10.1007/s00464-013-3141-y
  12. Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg 2005;15:1304-1308 https://doi.org/10.1381/096089205774512663
  13. Greenfield LJ. Complications of gastric surgery. In: Greenfield LJ, ed. Complications in surgery and trauma. Philadelphia: Lippincott, 1990:457-467
  14. Yu J, Turner MA, Cho SR, Fulcher AS, DeMaria EJ, Kellum JM, et al. Normal anatomy and complications after gastric bypass surgery: helical CT findings. Radiology 2004;231:753-760 https://doi.org/10.1148/radiol.2313030546
  15. Byrne TK. Complications of surgery for obesity. Surg Clin North Am 2001;81:1181-1193, vii-viii https://doi.org/10.1016/S0039-6109(05)70190-0
  16. Akkary E, Duffy A, Bell R. Deciphering the sleeve: technique, indications, efficacy, and safety of sleeve gastrectomy. Obes Surg 2008;18:1323-1329 https://doi.org/10.1007/s11695-008-9551-6
  17. Koehler RE, Halverson JD. Radiographic abnormalities after gastric bypass. AJR Am J Roentgenol 1982;138:267-270 https://doi.org/10.2214/ajr.138.2.267
  18. Blachar A, Federle MP. Gastrointestinal complications of laparoscopic roux-en-Y gastric bypass surgery in patients who are morbidly obese: findings on radiography and CT. AJR Am J Roentgenol 2002;179:1437-1442 https://doi.org/10.2214/ajr.179.6.1791437
  19. Podnos YD, Jimenez JC, Wilson SE, Stevens CM, Nguyen NT. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg 2003;138:957-961 https://doi.org/10.1001/archsurg.138.9.957
  20. Carbajo M, Garcia-Caballero M, Toledano M, Osorio D, Garcia- Lanza C, Carmona JA. One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg 2005;15:398-404 https://doi.org/10.1381/0960892053576677
  21. Noun R, Skaff J, Riachi E, Daher R, Antoun NA, Nasr M. One thousand consecutive mini-gastric bypass: short- and longterm outcome. Obes Surg 2012;22:697-703 https://doi.org/10.1007/s11695-012-0618-z
  22. Csendes A, Burdiles P, Burgos AM, Maluenda F, Diaz JC. Conservative management of anastomotic leaks after 557 open gastric bypasses. Obes Surg 2005;15:1252-1256 https://doi.org/10.1381/096089205774512410
  23. Jordan JH, Hocking MP, Rout WR, Woodward ER. Marginal ulcer following gastric bypass for morbid obesity. Am Surg 1991;57:286-288
  24. Rasmussen JJ, Fuller W, Ali MR. Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients. Surg Endosc 2007;21:1090-1094 https://doi.org/10.1007/s00464-007-9285-x
  25. Wang W, Wei PL, Lee YC, Huang MT, Chiu CC, Lee WJ. Shortterm results of laparoscopic mini-gastric bypass. Obes Surg 2005;15:648-654 https://doi.org/10.1381/0960892053923752
  26. Papavramidis S, Deligianidis N, Papavramidis T, Sapalidis K, Katsamakas M, Gamvros O. Laparoscopic cholecystectomy after bariatric surgery. Surg Endosc 2003;17:1061-1064 https://doi.org/10.1007/s00464-002-9169-z
  27. Fidler J, Paulson EK, Layfield L. CT evaluation of acute cholecystitis: findings and usefulness in diagnosis. AJR Am J Roentgenol 1996;166:1085-1088 https://doi.org/10.2214/ajr.166.5.8615248
  28. Macgregor AM, Pickens NE, Thoburn EK. Perforated peptic ulcer following gastric bypass for obesity. Am Surg 1999;65:222-225

Cited by

  1. Controversies and Pitfalls of Imaging Patients Postoperative Bariatric Surgery vol.4, pp.5, 2015, https://doi.org/10.1007/s40134-016-0152-1
  2. MINI-GASTRIC BYPASS: DESCRIPTION OF THE TECHNIQUE AND PRELIMINARY RESULTS vol.30, pp.4, 2015, https://doi.org/10.1590/0102-6720201700040009
  3. A Clinical Decision Support System for Predicting the Early Complications of One-Anastomosis Gastric Bypass Surgery vol.29, pp.7, 2015, https://doi.org/10.1007/s11695-019-03849-w
  4. Normal and Abnormal Postoperative Imaging Findings after Gastric Oncologic and Bariatric Surgery vol.21, pp.7, 2015, https://doi.org/10.3348/kjr.2019.0822
  5. Anastomotic Gastro-Jejunal Ulcer Perforation Following One Anastomosis Gastric Bypass: Clinical Presentation and Options of Management-Case Series and Review of Literature vol.30, pp.6, 2015, https://doi.org/10.1007/s11695-020-04423-5
  6. Evaluation of the Effects of Bariatric Surgery in Terms of Weight Loss and Diabetes Remission in the Indian Population vol.27, pp.4, 2021, https://doi.org/10.1159/000518856