Early Routine Upper Gastrointestinal Contrast Study Following Bariatric Surgery: an Indispensable Postoperative Care or a Medicolegal Heritage?

Obes Surg. 2019 Jun;29(6):1995-1998. doi: 10.1007/s11695-019-03850-3.

Abstract

Concerns still exist regarding the role of early routine upper gastrointestinal contrast study (UGI) after bariatric procedures for detection of early complications. We reviewed our database to identify patients who underwent laparoscopic primary or redo surgery (previously placement of adjustable gastric banding), between January 2012 and December 2017. All the patients underwent UGI within 48 h after surgery. Among 1094 patients, early UGI was abnormal in 5 patients: in 4 cases a leak (one false positive) and in one case stenosis (one true positive) were suspected. In this clinical setting, five leaks were observed and required surgical re-exploration: 3 correctly identified and 2 not detected at UGI. Overall, 3 patients developed anastomotic stenosis. Our data suggest that early routine UGI after bariatric procedures has limited utility.

Keywords: Bariatric surgery; Complications; Leakage; Medicolegal issue; Personalized medicine; Stenosis; Upper gastrointestinal contrast study.

MeSH terms

  • Adult
  • Aged
  • Bariatric Surgery* / rehabilitation
  • Constriction, Pathologic / diagnosis
  • Constriction, Pathologic / surgery
  • Contrast Media / therapeutic use
  • Diagnostic Techniques, Digestive System*
  • Diagnostic Tests, Routine
  • Early Diagnosis
  • Female
  • Humans
  • Jurisprudence
  • Laparoscopy / methods
  • Laparoscopy / rehabilitation
  • Male
  • Medical Futility / legislation & jurisprudence
  • Middle Aged
  • Obesity, Morbid / diagnosis
  • Obesity, Morbid / surgery*
  • Postoperative Care / legislation & jurisprudence
  • Postoperative Care / methods*
  • Postoperative Complications / diagnosis*
  • Predictive Value of Tests
  • Retrospective Studies
  • Treatment Outcome
  • Upper Gastrointestinal Tract / diagnostic imaging*
  • Upper Gastrointestinal Tract / surgery
  • Young Adult

Substances

  • Contrast Media