Complications of antireflux surgery for management of gastroesophageal reflux disease (GERD)
Nissen FDP: Complete (360°) FDP
Approach: Laparoscopic or open FDP
Gastric fundus wrapped 360° around intraabdominal esophagus to create antireflux valve
Concomitant hiatal hernia (HH) is reduced; diaphragmatic esophageal hiatus sutured
Toupet FDP: Partial (270°) FDP
Posterior hemivalve created
Belsey Mark IV repair: Open surgical; 240° FDP wrap around left lateral aspect of distal esophagus
Fundus sutured to intraabdominal esophagus; acute esophagogastric junction angle (angle of His)
Can also be performed via minimally invasive techniques
IMAGING
General Features
Radiographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Hesse UJ et al: Intraoperative conversion and complications in robotic assisted primary and redo gastric bypass surgery. J Robot Surg. ePub, 2021
Lall C et al: What the radiologist needs to know about gastrointestinal endoscopic surgical procedures. Abdom Radiol (NY). 43(6):1482-93, 2018
Zarzour JG et al: Anti-reflux procedures: complications, radiologic findings, and surgical and gastroenterologic perspectives. Abdom Radiol (NY). 43(6):1308-18, 2018
Carbo AI et al: Imaging findings of successful and failed fundoplication. Radiographics. 34(7):1873-84, 2014
Schijven MP et al: Laparoscopic surgery for gastro-esophageal acid reflux disease. Best Pract Res Clin Gastroenterol. 28(1):97-109, 2014
Jobe BA et al: Preoperative diagnostic workup before antireflux surgery: an evidence and experience-based consensus of the Esophageal Diagnostic Advisory Panel. J Am Coll Surg. 217(4):586-97, 2013
LeBedis CA et al: The diagnostic and therapeutic role of imaging in postoperative complications of esophageal surgery. Semin Ultrasound CT MR. 34(4):288-98, 2013
Epstein D et al: Laparoscopic fundoplication compared with medical management for gastro-oesophageal reflux disease: cost effectiveness study. BMJ. 339:b2576, 2009
Furga P et al: [The outcomes of treatment of gastroesophageal reflux disease with laparoscopic "floppy" fundoplication.] Pol Merkur Lekarski. 26(155):395-8, 2009
Hamdy E et al: Response of atypical symptoms of GERD to antireflux surgery. Hepatogastroenterology. 56(90):403-6, 2009
Baker ME et al: Gastroesophageal reflux disease: integrating the barium esophagram before and after antireflux surgery. Radiology. 243(2):329-39, 2007
Graziano K et al: Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure. Surg Endosc. 17(5):704-7, 2003
Fernando HC et al: Outcomes of laparoscopic Toupet compared to laparoscopic Nissen fundoplication. Surg Endosc. 16(6):905-8, 2002
Hainaux B et al: Intrathoracic migration of the wrap after laparoscopic Nissen fundoplication: radiologic evaluation. AJR Am J Roentgenol. 178(4):859-62, 2002
Waring JP: Postfundoplication complications. Prevention and management. Gastroenterol Clin North Am. 28(4):1007-19, viii-ix, 1999
Related Anatomy
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References
Tables
Tables
KEY FACTS
Terminology
Imaging
Diagnostic Checklist
TERMINOLOGY
Abbreviations
Fundoplication (FDP)
Definitions
Complications of antireflux surgery for management of gastroesophageal reflux disease (GERD)
Nissen FDP: Complete (360°) FDP
Approach: Laparoscopic or open FDP
Gastric fundus wrapped 360° around intraabdominal esophagus to create antireflux valve
Concomitant hiatal hernia (HH) is reduced; diaphragmatic esophageal hiatus sutured
Toupet FDP: Partial (270°) FDP
Posterior hemivalve created
Belsey Mark IV repair: Open surgical; 240° FDP wrap around left lateral aspect of distal esophagus
Fundus sutured to intraabdominal esophagus; acute esophagogastric junction angle (angle of His)
Can also be performed via minimally invasive techniques
IMAGING
General Features
Radiographic Findings
CT Findings
Imaging Recommendations
DIFFERENTIAL DIAGNOSIS
PATHOLOGY
General Features
CLINICAL ISSUES
Presentation
Demographics
Natural History & Prognosis
Treatment
DIAGNOSTIC CHECKLIST
Consider
Selected References
Hesse UJ et al: Intraoperative conversion and complications in robotic assisted primary and redo gastric bypass surgery. J Robot Surg. ePub, 2021
Lall C et al: What the radiologist needs to know about gastrointestinal endoscopic surgical procedures. Abdom Radiol (NY). 43(6):1482-93, 2018
Zarzour JG et al: Anti-reflux procedures: complications, radiologic findings, and surgical and gastroenterologic perspectives. Abdom Radiol (NY). 43(6):1308-18, 2018
Carbo AI et al: Imaging findings of successful and failed fundoplication. Radiographics. 34(7):1873-84, 2014
Schijven MP et al: Laparoscopic surgery for gastro-esophageal acid reflux disease. Best Pract Res Clin Gastroenterol. 28(1):97-109, 2014
Jobe BA et al: Preoperative diagnostic workup before antireflux surgery: an evidence and experience-based consensus of the Esophageal Diagnostic Advisory Panel. J Am Coll Surg. 217(4):586-97, 2013
LeBedis CA et al: The diagnostic and therapeutic role of imaging in postoperative complications of esophageal surgery. Semin Ultrasound CT MR. 34(4):288-98, 2013
Epstein D et al: Laparoscopic fundoplication compared with medical management for gastro-oesophageal reflux disease: cost effectiveness study. BMJ. 339:b2576, 2009
Furga P et al: [The outcomes of treatment of gastroesophageal reflux disease with laparoscopic "floppy" fundoplication.] Pol Merkur Lekarski. 26(155):395-8, 2009
Hamdy E et al: Response of atypical symptoms of GERD to antireflux surgery. Hepatogastroenterology. 56(90):403-6, 2009
Baker ME et al: Gastroesophageal reflux disease: integrating the barium esophagram before and after antireflux surgery. Radiology. 243(2):329-39, 2007
Graziano K et al: Recurrence after laparoscopic and open Nissen fundoplication: a comparison of the mechanisms of failure. Surg Endosc. 17(5):704-7, 2003
Fernando HC et al: Outcomes of laparoscopic Toupet compared to laparoscopic Nissen fundoplication. Surg Endosc. 16(6):905-8, 2002
Hainaux B et al: Intrathoracic migration of the wrap after laparoscopic Nissen fundoplication: radiologic evaluation. AJR Am J Roentgenol. 178(4):859-62, 2002