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INTRODUCTION: Complications after bariatric procedures are the most difficult to diagnose among all complications in abdominal surgery. Furthermore, they are extremely difficult to treat conservatively and surgically. Laparoscopic treatment of complications after bariatric procedures requires great skills. Complications after laparoscopic adjustable gastric banding (LAGB) are remarkably diverse. AIM: Presentation of complications after LAGB in our own material. MATERIAL AND METHODS: From 2005 to 2010, in the 1(st) Department of General and Endocrine Surgery, in 110 patients adjustable gastric banding was applied. All procedures were conducted laparoscopically. The group consisted of 76 women (69.1%) and 34 men (30.9%). The average age of women was 37.7 ±13.80 years old. The average age of men was 38.9 ±11.50 years old. The average body mass was 128.5 ±24.35 kg for women and 125.4 ±23.60 kg for men. The average body mass index (BMI) for women was 44.08 ±3.03 kg/m(2) and for men 43.66 ±2.90 kg/m(2). The average waist circumference was 113.5 ±12.75 cm in women and for men it was 124.40 ±14.8 cm. RESULTS: In the analysed material, which consisted of 110 patients after LAGB, 36% developed at least 1 complication. Among early complications, injury of diaphragm, pneumothorax, pleural empyema, gastric perforation and thrombophlebitis were observed. Among late complications, oesophagitis, infections around the port, migration of the gastric band into the gastric lumen, band slippage, vomiting and lack of body mass loss were observed. The most common reasons for the removal of the band were band slippage, its migration to the gastric lumen and extension of the gastric reservoir. CONCLUSIONS: The LAGB is a relatively easy procedure with a short time of performance and short hospitalization. However, it can bring the risk of intraoperative, perioperative and late complications which require surgical intervention. The present research results are comparable to world data. Complications after LAGB were observed the most frequently in the first years of application of the procedure.
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BACKGROUND: Carcinoma of the pancreas is one of the most malignant tumors. Symptoms are usually nonspecific and insidious, such that the cancer is advanced by the time of diagnosis. The aim of the study was to assess the usefulness of MRI and MRCP in the diagnosis of patients suspected of pancreatic carcinoma and to define the role of these methods in the evaluation of resectability of pancreatic cancer in comparison with surgical findings. MATERIAL/METHODS: Forty-seven patients (32 men and 15 women) aged 46-81 had undergone MRI and MRCP examination of the upper abdomen on a 1.5 T system with a standard flexible surface coil. The results of those tests were compared with surgical and histopathological findings. The capacity of MR and MRCP to detect pathological mass, assess the nature of the disease process, and accurately assess the resectability of the malignant lesion were evaluated. In the statistical analysis the chi-squared and Fisher's precise tests were performed. RESULTS: Statistical analysis showed 87% sensitivity, 97% specificity, and 95% accuracy of MRI and MRCP in the evaluation of the nature of tumors within the pancreas and 100% sensitivity, 90% specificity, and 93% accuracy in determining the resectability of the lesion. The positive predictive value came to 83%, while the negative predictive value was 100%. The kappa compatibility index in comparison with surgical findings was 0.85714. CONCLUSIONS: MR and MRCP is an important diagnostic method in assessing pancreatic tumors. It is very useful in differential diagnosis and determination of tumor resectability.