The utility of routine postoperative upper gastrointestinal swallow studies following laparoscopic sleeve gastrectomy.

Abstract:

:Laparoscopic sleeve gastrectomy (LSG) has grown in popularity in recent years for the treatment of morbid obesity. Controversy exists regarding the usefulness of upper gastrointestinal (UGI) swallow studies on the first postoperative day in detecting possible complications. The aim of our study was to determine the efficacy and cost benefit of routine UGI studies on the first postoperative day following LSG. We retrospectively reviewed the hospital's records to identify patients who underwent LSG between January 2012 and June 2013. All patients had iodine-based contrast swallow study on the first postoperative day. Reports from all imaging studies and medical files were retrospectively reviewed, and complications were recorded. The Institutional Review Board waived the requirement for informed consent. During the study period, 722 patients underwent LSG. Mean BMI was 43 kg/m(2) (range 25-70). Of the 722 UGI studies, 721 were normal. The 1 abnormal study showed complete obstruction due to an incarcerated hiatal hernia. Five patients presented with a leak (0.7%). UGI swallow studies failed to detect any of the leaks resulting in a sensitivity of 0%. All leaks were apparent on computed tomography (CT) scans on postoperative days 2, 5, 7, 23, and 90. The total cost of the UGI swallow studies was $180,500. Performing routine UGI studies on the first postoperative day following LSG is clearly not cost beneficial. UGI contrast studies are not efficient to screen for suture line leaks. We recommend obtaining a CT scan when there is clinical suspicion for a complication.

journal_name

Obes Surg

journal_title

Obesity surgery

authors

Mizrahi I,Tabak A,Grinbaum R,Beglaibter N,Eid A,Simanovsky N,Hiller N

doi

10.1007/s11695-014-1243-9

subject

Has Abstract

pub_date

2014-09-01 00:00:00

pages

1415-9

issue

9

eissn

0960-8923

issn

1708-0428

journal_volume

24

pub_type

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