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Usefulness of Preoperative Trans-Abdominal Ultrasound Prior to Bariatric Surgery
SN Comprehensive Clinical Medicine Pub Date : 2020-01-03 , DOI: 10.1007/s42399-019-00213-y
Bhagyam Nagarajan , Karan Gupta , Amrit Nasta , Autkar Gayatri , Ramen Goel

An enlarged left lobe of liver can complicate bariatric surgery. Preoperative ultrasound of the abdomen is routinely performed in bariatric patients to measure the liver, particularly the left lobe, as well as to record any ancillary findings such as gallstones. Our study aims to evaluate the reliability of ultrasound in evaluating the craniocaudal length of the left lobe of the liver vis-a-vis intraoperative measurements. It also aims to assess the impact of ancillary findings detected on ultrasound, on the pre-surgical preparation and follow-up of such patients. Forty patients who were to undergo bariatric surgery in our hospital between June 2018 and May 2019 were included in this study. All of these patients underwent preoperative ultrasound. The measurements of the left lobe of liver evaluated on ultrasound were compared with the intraoperative measurements. Mean preoperative BMI for the forty patients was 41.47 kg/m2. On applying the paired t test, the left liver lobe measurements calculated by our ultrasound technique correlated with intraoperative measurements. The left liver lobe length measured less than 15 cm in all 40 patients. Ultrasound detected ancillary findings in 8 (20%) patients. Ultrasound showed fatty infiltration of liver in approximately 80% of the patients with a trend towards increasing incidence of fatty change with increasing BMI. Our study showed that left liver lobe measurements calculated by preoperative ultrasound correlate with intraoperative measurements. Ancillary ultrasound findings helped the surgeon in preparing for the bariatric surgery and may modify the follow-up protocol in such patients.

中文翻译:

减肥手术前术前经腹超声检查的实用性

肝脏左叶增大会使减肥手术复杂化。肥胖患者通常会进行术前腹部超声检查,以测量肝脏(尤其是左叶)以及记录任何辅助检查结果,例如胆结石。我们的研究旨在评估超声对评估术中肝脏左叶颅尾长的可靠性。它还旨在评估检测到的辅助检查结果对超声的影响,对此类患者的术前准备和随访。该研究纳入了2018年6月至2019年5月间在我院进行减肥手术的40名患者。所有这些患者均接受了术前超声检查。超声评估的肝左叶测量值与术中测量值进行了比较。40名患者的术前平均BMI为41.47 kg / m2。应用配对t检验时,通过我们的超声技术计算出的左肝叶测量值与术中测量值相关。所有40例患者的左肝叶长度均小于15厘米。超声检测到8例(20%)患者的辅助检查结果。超声显示约80%的患者肝脏脂肪浸润,并且随着BMI的增加,脂肪变化的发生率呈增加趋势。我们的研究表明,术前超声计算得出的左肝叶测量值与术中测量值相关。辅助超声检查结果有助于外科医生做好减肥手术的准备,并可能会修改此类患者的随访方案。
更新日期:2020-01-03
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