Routine postoperative upper gastroesophageal imaging is unnecessary after laparoscopic Roux-en-Y gastric bypass.
Routine early postoperative upper gastroesophageal imaging (UGI) is often used in laparoscopic Roux-en-Y gastric bypass (LRYGB) procedures to confirm anastomotic patency and to exclude leaks. The aim of our study was to assess the usefulness of this practice. From January 2003 to November 2004, 322 LRYGB cases were performed using linear staplers for the gastrojejunostomy and jejuno-jejunostomy anastomoses. As part of our protocol, all patients received a Gastrograffin (Mallinkrodt, Inc., St Louis, Missouri) UGI on postoperative Day 1. The same radiological techniques were used and the same radiological team reviewed all films. Abnormal films were identified. In addition, patient demographics, time to discharge, and complications were collected and analyzed in a prospective database. There were no anastomotic leaks or obstructions. However, 42 of 322 (13%) studies demonstrated delayed gastric emptying. There were no statistically significant differences between patients with normal and delayed UGI studies. Routine UGI studies did not contribute significantly to patient care, and its routine use was subsequently abandoned.
Bertucci
William
W
Section for Minimally Invasive and Bariatric Surgery, UCLA Department of Surgery, Los Angeles, California, USA.
White
Stephen
S
Yadegar
John
J
Patel
Kaushal
K
Han
Soo Hwa
SH
Blocker
Oliver
O
Frickel
Deborah
D
Kadell
Barbara
B
Mehran
Amir
A
Gracia
Carlos
C
Dutson
Erik
E
D000328:Adult; D000713:Anastomosis, Roux-en-Y / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D004947:Esophagus / Q000000981:diagnostic imaging*; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects / Q000379:methods*; D005746:Gastric Emptying / Q000502:physiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods; D007902:Length of Stay; D008297:Male; D010351:Patient Discharge; D011182:Postoperative Care; D011183:Postoperative Complications; D011446:Prospective Studies; D011859:Radiography; D013270:Stomach / Q000000981:diagnostic imaging*; D013528:Surgical Staplers / Q000009:adverse effects
D003287:Contrast Media; D003974:Diatrizoate Meglumine