title: [Routine fluoroscopic investigations after primary bariatric surgery].
abstract: BACKGROUND
  Staple line and anastomotic leakages are life-threatening complications after bariatric surgery. Upper gastrointestinal (GI) tract X-ray examination with oral administration of a water-soluble contrast agent can be used to detect leaks. The aim of this study was to evaluate the impact of routine upper GI tract fluoroscopy after primary bariatric surgery.
  
  
  METHODS
  Between January 2009 and December 2014 a total of 658 bariatric interventions were carried out of which 442 were primary bariatric operations. Included in this single center study were 307 sleeve gastrectomies and 135 Roux-en-Y gastric bypasses. Up to December 2012 upper GI tract fluoroscopy was performed routinely between the first and third postoperative days and the detection of leakages was evaluated.
  
  
  RESULTS
  In the investigation period 8 leakages (2.6 %) after sleeve gastrectomy, 1 anastomotic leakage in gastrojejunostomy and 1 in jejunojejunostomy after Roux-en-Y gastric bypass occurred. All patients developed clinical symptoms, such as abdominal pain, tachycardia or fever. In one case the leakage was detected by upper GI fluoroscopy and in nine cases radiological findings were unremarkable. No leakages were detected in asymptomatic patients.
  
  
  CONCLUSIONS
  Routine upper GI fluoroscopy is not recommended for uneventful postoperative courses after primary bariatric surgery.
authors.affiliation: Klinik für Allgemein- und Visceralchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland. daniel.gaertner@klinikum-karlsruhe.de.
authors.forename: D
authors.initials: D
authors.lastname: Gärtner
authors.affiliation: Klinik für Allgemein- und Visceralchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Ernst
authors.affiliation: Klinik für Allgemein- und Visceralchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
authors.forename: K
authors.initials: K
authors.lastname: Fedtke
authors.affiliation: Klinik für Gefäß- und Thoraxchirurgie, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland.
authors.forename: J
authors.initials: J
authors.lastname: Jenkner
authors.affiliation: Klinik für Allgemein- und Visceralchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
authors.forename: A
authors.initials: A
authors.lastname: Schöttler
authors.affiliation: Institut für diagnostische und interventionelle Radiologie, Städtisches Klinikum Karlsruhe, Karlsruhe, Deutschland.
authors.forename: P
authors.initials: P
authors.lastname: Reimer
authors.affiliation: Klinik und Poliklinik für Endokrinologie und Nephrologie, Universitätsklinikum Leipzig, Leipzig, Deutschland.
authors.forename: M
authors.initials: M
authors.lastname: Blüher
authors.affiliation: Klinik für Allgemein- und Visceralchirurgie, Städtisches Klinikum Karlsruhe, Moltkestr. 90, 76133, Karlsruhe, Deutschland.
authors.forename: M R
authors.initials: MR
authors.lastname: Schön
mesh_terms: D000328:Adult; D000713:Anastomosis, Roux-en-Y; D057868:Anastomotic Leak / Q000175:diagnosis; D050110:Bariatric Surgery; D005260:Female; D005471:Fluoroscopy; D015390:Gastric Bypass; D015391:Gastroplasty; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D013528:Surgical Staplers; D013529:Surgical Wound Dehiscence / Q000175:diagnosis
keywords: Fluoroscopy; Roux en Y gastric bypass; Sleeve gastrectomy; Staple line leakage; Stenosis