ARRS 2022 Abstracts

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E1931. Slimming the Odds: Surgical Weight Loss Interventions, Imaging of Postsurgical Appearance and Its Complications
Authors
  1. Michael Pan; Santa Clara Valley Medical Center
  2. Luyao Shen; Stanford University Medical Center
  3. Edwina Chang; Santa Clara Valley Medical Center; Stanford University Medical Center
Background
Morbid obesity has become an epidemic in the United States. Given its proven ability to reduce associated comorbidities, such as hypertension and diabetes, bariatric surgery has become an increasingly popular form of treatment for morbid obesity. Bariatric surgery has quickly evolved since jejunoileal bypass in the 1950s to involve techniques such as gastric bypass, Roux-en-Y gastric bypass, biliopancreatic diversion, and duodenal switch. Most recently, sleeve gastrectomy and gastric banding have become more popular. Given the increasing prevalence of bariatric surgery, and evolving techniques, it is essential for the radiologist to understand the normal postsurgical anatomy and complications pertaining to each type of bariatric surgery. This educational exhibit will review the spectrum of bariatric surgery and its complications with multimodality imaging, including fluoroscopy, CT, and MRI.

Educational Goals / Teaching Points
The goals of this exhibit are to understand the evolution of bariatric surgery and its prevalence; understand the normal postsurgical anatomy pertaining to each type of bariatric surgery; review the spectrum of complications specific to each type of bariatric surgery, with reference to timeframe postopertively; and discuss imaging tips on obtaining the best fluoroscopy and CT images.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
The exhibit will include: evolution of bariatric surgery since the 1950s; malabsorptive mechanism (jejunoileal bypass); restrictive mechanism (horizontal gastroplasty, vertical banded gastroplasty, gastric banding, sleeve gastrectomy); malabsorptive and restrictive mechanisms (gastric bypass, biliopancreatic diversion, duodenal switch, Roux-en-Y gastric bypass); and new trends (gastric balloon, endoscopic sleeve gastroplasty, percutaneous gastrostomy tube).

Conclusion
With the increasing obesity epidemic and effectiveness of bariatric surgery, bariatric surgery has become more common in the United States. With its unique postsurgical anatomy and consequent unique complications, it has become essential for both the novice and experienced radiologist to be aware of the different types of bariatric surgery, new trends, and associated complications. This educational exhibit will review the myriad of surgical weight loss interventions, including gastric bypass, Roux-en-Y gastric bypass, biliopancreatic diversion, duodenal switch, sleeve gastrectomy, and gastric banding, as well as newer techniques that are still under review, with multimodality imaging correlation.