Adalet Elcin Yıldız, completed school at Hacettepe University and finished her Radiolgy residency at the same university. She published more than 20 papers in reputed.She is currently an assistant professor of radiology.
Obesity is a modern world epidemics and 50% of European population between 35-65 years are either overweight or obese.
Sleeve gastrectomy gained popularity as a practical obesity surgery technique.One of the most drastic complication aftersleeve gastrectomy is staple line leak, occuring between 1 and 3 % of patients.Prompt management of staple line leak is essential
in avoiding prolonged hospital stay and mortality.Recent studies showed that radiologic contrast agent upper gastrointestinal
examination has low senstivity for detection of leaks.In case of clinical suspicion of a leak, computed tomography scan with oral
contrast agent is recommended.But there is not enough prospective data on efficacy and methodology (timing,volume of oral
contrast,etc) of routine computed tomography after sleeve gastrectomy.Our objective in this study was to prospectively evaluate
the efficacy of upper abdomen computed tomography on postoperative day 3 after sleeve gastrectomy using only 50cc oral
contrast agent in 500cc of drinking water.Patients were instructed to drink the last 50cc of water just before lying on gantry.For
this purpose,168 patients who underwent laparoscopic sleeve gastrectomy were included in the study.Patients were started with
oral feeds if computed tomography was negative for a leak and discharged.They were followed as outpatient on 1st, 3rd, 6th and 12thmonths.None of the patients with a tomography negative for a leak had a clinically manifest leak on follow up (Senstivity 100%).
Our study showed that using minimal amount of only oral contrast agent,accurate timing and only with upper abdomen sections
leaks can be detected with very high accuracy.