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.
Keywords
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References
- Long-term results of laparoscopic sleeve gastrectomy for obesity.Ann Surg. 2010; 252: 319-324
- Technical aspects of laparoscopic sleeve gastrectomy in 25 morbidly obese patients.Obes Surg. 2007; 17: 722-727
- Laparoscopic sleeve gastrectomy is a safe and effective bariatric procedure for the lower BMI (35.0-43.0 kg/m2) population.Obes Surg. 2011; 21: 1168-1171
- Laparoscopic sleeve gastrectomy as a single-stage procedure for the treatment of morbid obesity and the resulting quality of life, resolution of comorbidities, food tolerance, and 6-year weight loss.Surg Endosc. 2011; 28: 2498-2504
- Laparoscopic sleeve gastrectomy with minimal morbidity: early results in 120 morbidly obese patients.Obes Surg. 2008; 18: 1567-1570
- Experience with laparoscopic sleeve gastrectomy for morbid versus super morbid obesity.Obes Surg. 2009; 19: 1371-1376
- Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese.J Gastrointest Surg. 2008; 12: 662-667
Sakran N, Goitein D, Raziel A, et al. Gastric leaks after sleeve gastrectomy: a multicenter experience with 2,834 patients. Surg Endosc. In press.
- Gastric leak after laparoscopic-sleeve gastrectomy for obesity.Obes Surg. 2009; 19: 1672-1677
- The First International Consensus Summit for Sleeve Gastrectomy (SG), New York, October 25-27 2007.Obes Surg. 2008; 18: 487-496
- The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21 2009.Surg Obes Relat Dis. 2009; 5: 476-485
- Upper gastrointestinal swallow study following bariatric surgery: institutional review and review of the literature.Obes Surg. 2012; 22: 1039-1043
- Back to basics—clinical diagnosis in bariatric surgery. Routine drains and upper GI series are unnecessary.Surg Endosc. 2007; 21: 2268-2271
- Management of leaks after laparoscopic sleeve gastrectomy in patients with obesity.J Gastrointest Surg. 2010; 14: 1343-1348
- Sleeve gastrectomy as a bariatric procedure.Surg Obes Relat Dis. 2007; 3: 573-576
- Gastric leak after laparoscopic sleeve gastrectomy.Obes Surg. 2010; 10: 1303-1311
- Sleeve gastrectomy and the risk of a leak: a systematic analysis of 4,888 patients.Surg Endosc. 2012; 26: 1509-1515
- Sleeve gastrectomy: radiologic patterns after surgery.Surg Endosc. 2009; 23: 1559-1563
- Total gastrectomy with or without abdominal drains. A prospective randomized trial.Rev Esp Enferm Dig. 2005; 97: 562-569
- Gastric cancer surgery without drains: a prospective randomized trial.J Gastrointest Surg. 2004; 8: 727-732
- Routine postoperative upper gastroesophageal imaging is unnecessary after laparoscopic Roux-en-Y gastric bypass.Am Surg. 2006; 72: 862-864
- Laparoscopic sleeve gastrectomy, 529 cases without a leak: short-term results and technical considerations.Obes Surg. 2011; 21: 146-150
- International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12,000 cases.Surg Obes Relat Dis. 2012; 8: 8-19
- The science of stapling and leaks.Obes Surg. 2004; 14: 1290-1298
- Esophageal manometry in 95 healthy volunteers. Variability of pressures with age and frequency of “abnormal” contractions.Dig Dis Sci. 1987; 32: 583-592
Article info
Publication history
Published online: October 11, 2013
Received in revised form:
April 17,
2013
Received:
February 18,
2013
Footnotes
The authors declare no conflicts of interest.
Identification
Copyright
© 2014 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
