title: Routine upper gastrointestinal swallow studies after laparoscopic sleeve gastrectomy are unnecessary.
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.
authors.affiliation: Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria. Electronic address: reinhard.mittermair@aon.at.
authors.forename: Reinhard
authors.initials: R
authors.lastname: Mittermair
authors.affiliation: Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Robert
authors.initials: R
authors.lastname: Sucher
authors.affiliation: Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Alexander
authors.initials: A
authors.lastname: Perathoner
authors.affiliation: Department of Visceral, Transplant and Thoracic Surgery, Innsbruck Medical University, Anichstrasse 35, 6020 Innsbruck, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Wykypiel
mesh_terms: D000328:Adult; D000368:Aged; D057868:Anastomotic Leak / Q000000981:diagnostic imaging*; D003287:Contrast Media; D003974:Diatrizoate Meglumine; D005260:Female; D005743:Gastrectomy / Q000379:methods*; D006471:Gastrointestinal Hemorrhage / Q000000981:diagnostic imaging*; D005773:Gastroscopy / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D010147:Pain Measurement; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D017792:Surgical Stapling; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome; D019564:Unnecessary Procedures; D041742:Upper Gastrointestinal Tract / Q000000981:diagnostic imaging*
chemical_list: D003287:Contrast Media; D003974:Diatrizoate Meglumine
keywords: Bariatric surgery; Complications; Obesity; Sleeve gastrectomy; UGI study