Clinical implication of positive oral contrast computed tomography for the evaluation of postoperative leakage after gastrectomy for gastric cancer.
OBJECTIVE
To evaluate the clinical usefulness of positive oral contrast computed tomography (CT) for the detection of leakage and its relationship with the immediate postoperative outcome after gastrectomy for gastric cancer.


METHODS
A total of 210 patients with a clinical suspicion of leakage after gastrectomy for gastric cancer underwent a positive oral contrast CT. Two radiologists retrospectively reviewed the CT images, recorded the presence of extraluminal contrast leakage, and graded the amount of leaked contrast. The rate of postoperative intervention treatment, the length of postoperative hospital stay, and mortality rates were correlated with the presence and grades of leakage. Matching accuracy between CT and other diagnostic studies in detection of leakage was also evaluated.


RESULTS
There were 162 patients without extraluminal contrast leakage (77.1%), 13 with grade 1 leakage (6.2%), 19 with grade 2 (9.0%), and 16 with grade 3 (7.6%). Postoperative intervention rate, hospital stay, and mortality were significantly higher in patients with extraluminal contrast than those in patients without extraluminal contrast (P < 0.05). Postoperative hospital stays increased as the leakage grades increased (P = 0.0008). The matching accuracy between CT and other studies was 82.1% (n = 32/39).


CONCLUSIONS
Positive oral contrast CT can be a reliable tool for diagnosing postoperative leakage that requires further intervention after gastrectomy in gastric cancer patients, and the immediate postoperative outcome may be related with the grade of leaked contrast on CT.
Kim
Yeo-Eun
YE
Department of Radiology, Research Institute of Radiological Science, Yonsei University Health System, Seoul, Republic of Korea.
Lim
Joon Seok
JS
Hyung
Woo Jin
WJ
Lee
Sang Kil
SK
Choi
Jin-Young
JY
Noh
Sung Hoon
SH
Kim
Myeong-Jin
MJ
Kim
Ki Whang
KW
D000284:Administration, Oral; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003287:Contrast Media / Q000008:administration & dosage; D003974:Diatrizoate Meglumine / Q000008:administration & dosage; D005119:Extravasation of Diagnostic and Therapeutic Materials / Q000000981:diagnostic imaging* / Q000209:etiology; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects*; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D008297:Male; D008875:Middle Aged; D015588:Observer Variation; D011183:Postoperative Complications / Q000000981:diagnostic imaging* / Q000209:etiology; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012189:Retrospective Studies; D013270:Stomach / Q000000981:diagnostic imaging / Q000601:surgery; D013274:Stomach Neoplasms / Q000601:surgery*
D003287:Contrast Media; D003974:Diatrizoate Meglumine