外科减肥解剖和并发症的影像学表现

《外科减肥解剖和并发症的影像学表现》由会员上传分享，免费在线阅读，更多相关内容在行业资料-天天文库。

1、RadiologyofBariatricSurgery:AnatomyandComplicationsKevinSelbyGillianLieberman,MDMarch20081AgendaIndicationsforbariatricsurgeryNormalanatomyofbariatricsurgeryCommoncomplicationsofbariatricsurgeryFourinterestingcasesEpidemiologyofObesityintheUShttp:/

2、/www.cdc.gov/nccdphp/dnpa/obesity/trend/maps/3ObesityandMortalityObesity,measuredbybodymassindex(BMI),isanindependentpredictorofmortality.TheFraminghamHeartStudyconcluded:“Ifeveryonewereatoptimalweight,wewouldhave25percentlesscoronaryheartdisease,and

3、35percentlesscongestivefailureandbrainUpToDate:“OverviewofTherapyforObesityinAdults”infarctions.”4BariatricSurgeryisaTreatmentforMorbidObesityNIHGuidelinessupportbariatricsurgeryastherapyformorbidobesity:2HaveaBMI>40kg/mHaveaBMI35-39.9kg/m2andanasso

4、ciatedmajorcomorbidity(i.e.DM,HTN,OSA)ArerefractorytootherweightmanagementstrategiesNumberofsurgeriesincreasedfrom72,177to171,200proceduresperyearbetween2002and2005.5Long-termResultsofBariatricSurgeryPatientswhoundergobariatricsurgeryhavesignificant

5、lymoreweightlossat10yearsthanmatchedcontrolsubjects.NEJM20046NormalAnatomyIwww.lahey.org/images/Radiology/fluoroscopy_UGI.asp7NormalAnatomyIIwww.yoursurgery.com/.../images/SmBowelAnat.jpgwww.lahey.org/images/Radiology/fluoroscopy_UGI.asp8RestrictiveSur

6、gery:LaparoscopicAdjustableGastricBandingAdjustablebandisplacedaroundtheupperpartofthestomach,~2cmfromthegastroesophageal(GE)junction,formingasmallgastricpouchorneo-stomach.Limitsfoodintakewhenthestomachfillsandstretches.Accessportisplacedoutsideper

7、itonealcavity,sewnintothesurroundingfascia.NEJM20079NormalAppearanceofLapBandonChestX-RayLaparoscopicadjustablebandscanbeseenonchestX-ray(CXR).CXRisnotthemodalityofchoiceforevaluatinglapband.ThisstudywastakentoBandjustevaluatetheplacementofanbelowGE

8、junctionNGtube.PortforadjustmentofbandtightnessPACSBIDMC10NormalAppearanceofLapBandonFluoroscopyUpperGIfluoroscopywithbariumswallowisthemodalityofchoicetoevaluatetheproperplacementandfunctionofalapband.GastricpouchStomashouldbe3-4mm,a