SSAT - Ogaki Classification Using Water-Soluble Contrast Agent for the Management of Adhesive Small Bowel Obstruction: An Audit of 650 Consecutive Cases in Single Center

Back to 2016 Annual Meeting

Ogaki Classification Using Water-Soluble Contrast Agent for the Management of Adhesive Small Bowel Obstruction: An Audit of 650 Consecutive Cases in Single Center
Haruki Mori^*, Yuji Kaneoka
surgery, Ogaki Municipal Hospital, Ogaki, Gifu, Japan

Background: Several studies investigated the diagnostic and therapeutic role of water-soluble contrast agent (WSCA) in adhesive small bowel obstruction (ASBO), but there is no clear diagnostic classification for the therapeutic strategy. The aim of this study is to clarify the clinical value of classification using WSCA in ASBO.
Methods: Between January 2009 and September 2015, 650 consecutive patients with ASBO were included and received WSCA at a single institution. Abdominal X-rays were taken after 6 hours following WSCA administration and classified into four types. Type I was detected the complete obstructive point. Type II was failed reach to the colon. Type IIIA was reached to the colon with dilated small intestine. Type IIIB was reached the colon without dilated small intestine. Type I and II were subjected to surgical exploration. Type IIIA and IIIB were continued conservative treatment. If the patients with Type IIIA or IIIB showed clinical and radiologic findings of persistent obstruction following conservative treatment, surgery was performed. Their medical records were retrospectively analysed.
Results: Type I, II, IIIA and IIIB included 24, 73, 304, and 249 patients, respectively. The overall operative rate was 16.9%. In conservative group (Type IIIA and IIIB), 542 patients (98.0%) were successful treated without surgery. The operative rate was 3.6% (n=11/304) in Type IIIA group versus 0% (n=0/249) in Type IIIB group (p=0.001). Compared with Type IIIA, Type IIIB was associated with earlier oral intake restart (2.2 versus 2.4 days, p=0.005), shorter hospital stay (8.6 versus 10.6 days, p<0.001).
Conclusions: This classification using WSCA is clear and useful diagnostic classification for the therapeutic strategy in ASBO.

Back to 2016 Annual Meeting