Selective approach to use of upper gastroesophageal imaging study after laparoscopic Roux-en-Y gastric bypass

Routine postoperative upper gastrointestinal fluoroscopy is unnecessary after laparoscopic adjustable gastric band placement

“…Carter et al [9] found that UGI had a sensitivity of 43% and positive predictive value of 60%, with 99% of routine early postoperative UGIs negative for leak. White et al [3] observed over 500 patients and had a 0% leak rate, thus making the study unable to evaluate these parameters but suggesting that UGI is not necessary in their patient population. In lieu of routine UGI, these authors suggest a selective approach based on clinical factors.…”

“…Routine UGI after LAGB has been recommended as a standard [1,3,6]. However, there have been little published data to support this recommendation.…”

“…Bariatric surgery is recognized as one of the best, and perhaps only, long-term treatments for morbid obesity [2]. A variety of procedures have been introduced, and in 1993 the first adjustable gastric band was placed [3]. Since then, there have been several generations of bands along with the addition of the now standard laparoscopic technique [4].…”

The usefulness and costs of routine contrast studies after laparoscopic sleeve gastrectomy for detecting staple line leaks

“…Most conclude that routine Gastrografin swallow studies on POD 1 are not useful or costeffective methods of early detection of anasto motic leaks. 17,[29][30][31][32][33][34] However, 2 studies published on LRYGB have conducted sensitivity analyses comparing sensi tivies of clinical signs verus routine Gastrografin swallows. These 2 studies found clinical signs to be less sensitive and there fore support the use of routine contrast studies.…”

Routinemäßige Durchleuchtungsuntersuchungen nach bariatrischen Operationen

“…Die Mehrzahl anderer Autoren kommt in ihren aktuell publizierten Arbeiten zu vergleichbaren Ergebnissen [5,7,14,25,27,28] Eine intraoperative Dichtigkeitskontrolle durch Luftinsufflation über eine Magensonde, Instillation von Blaulösung als sog. Blauprobe oder wie im eigenen Vorgehen die routinemäßige intraoperative Gastroskopie wird von vielen Adipositaschirurgen regelhaft durchgeführt [16].…”