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Laparoscopic adjustable silicone gastric banding leakage assessed by 99mTc-pertechnetate scintigraphy
A C Van den Eeckhaut1, G M Villeirs, C Van de Wiele
1Department of Radiology, University Hospital Gent, Belgium.
Unlabelled:
The purpose of this study was to assess the value of 99mTc-pertechnetate scanning in the diagnosis of gastric banding leaks.
Methods:
Three patients with morbid obesity received laparoscopic adjustable silicone gastric banding (ASGB), but no significant weight reduction was obtained. To exclude band leakage as the cause, four scintigraphic procedures were performed, consisting of imaging the upper abdomen 30 min and 3 h after injection of 3 mL (111 MBq) pertechnetate solution into the ASGB reservoir. In one patient, the integrity of the ASGB device was first assessed radiologically after injection of a water-soluble contrast agent into the ASGB reservoir.
Results:
In two normally functioning ASGB devices, radiotracer was observed within the device on both early and late images. In two patients with a surgically proven small leak in the reservoir or the connecting tube, late images showed little tracer in the reservoir and the connecting tube. However, intense tracer accumulation was observed in the stomach as a result of resorption of pertechnetate in the subcutaneous or peritoneal blood vessels and subsequent gastric uptake. In one of the latter patients, radiographic assessment of the ASGB device revealed no abnormalities.
Conclusion:
99mTc-pertechnetate scanning is a valuable technique to diagnose small leaks in an ASGB device.