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Routine upper gastrointestinal swallow studies after laparoscopic sleeve gastrectomy are unnecessary

Authors
Journal
The American Journal of Surgery
0002-9610
Publisher
Elsevier
Volume
207
Issue
6
Identifiers
DOI: 10.1016/j.amjsurg.2013.06.015
Keywords
  • Obesity
  • Bariatric Surgery
  • Sleeve Gastrectomy
  • Complications
  • Ugi Study
Disciplines
  • Medicine

Abstract

Abstract Background Laparoscopic sleeve gastrectomy has gained popularity among bariatric surgeons. The purpose of this study was to evaluate the usefulness of early upper gastrointestinal (UGI) contrast studies in the detection of postoperative complications. Methods Radiographic reports were reviewed from April 2006 to January 2013. During that time, 161 patients underwent laparoscopic sleeve gastrectomy. All patients were submitted to UGI examination on postoperative day (POD) 1. Results Among the 161 patients who underwent UGI, no contrast leaks were found on POD 1. Three patients (1.9%) developed stapler line leaks near the gastroesophageal junction, which were diagnosed on PODs 3, 4, and 10. Gastroesophageal reflux in 5 patients (3.1%) and delayed gastroesophageal transit in 10 patients (6.2%) were detected. Conclusions The results of this study show that UGI series on POD 1 cannot assess the integrity of the gastric remnant. Early UGI series are not required as routine procedures in all operated patients. Computed tomographic swallow studies should be performed in patients who postoperatively develop clinical signs and symptoms of complications such as tachycardia, pain, or fever.

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