SIR 2024
Gastrointestinal Interventions
Abhinav Patel, MD
Fellow/Resident
Indiana University
Financial relationships: Full list of relationships is listed on the CME information page.
To describe common upper gastrointestinal surgeries and illustrate the implications of their postsurgical anatomy when approaching interventional procedures. To discuss common issues and pitfalls that may arise when performing procedures in this patient population.
Background:
There are a myriad of upper gastrointestinal surgeries commonly performed such as Roux-en-Y gastric bypass, Billroth I and II, Whipple procedure, Ivor-Lewis esophagectomy, gastric sleeve, and more. These surgeries result in significant anatomic variations and changes that can affect common interventional radiologic procedures including percutaneous gastrointestinal interventions, biliary interventions and visceral angiography. Thus, performing procedures on these patients require familiarity with the complex postsurgical anatomy.
Clinical Findings/Procedure Details:
In this exhibit we will (1) Review common indications for common upper GI surgeries. Discussion points will include but not be limited to Roux-en-Y gastric bypass, Billroth I and II, Whipple procedure, Ivor-Lewis esophagectomy, and gastric sleeve surgeries. (2) Detail the relevant post-surgical anatomy with several common upper gastrointestinal surgeries for interventional radiologists to be aware of. An emphasis on the gastrointestinal anatomic changes and pertinent alterations in vascular anatomy will be reviewed and illustrated. (3) Discuss implications or alterations in the technical approach for common interventional radiologic procedures with pertinent case examples.
Conclusion and/or Teaching Points: Patients with upper gastrointestinal surgeries are often seen by the interventional radiologist. Understanding their complex postsurgical anatomy is important when attempting interventional procedures.