Abstract
The aim of this study is to evaluate the results of routine and selective postoperative upper gastrointestinal series (UGIS) after Roux-en-Y gastric bypass (RYGB) for morbid obesity in different published series to assessing its utility and cost-effectiveness. A search in PubMed’s MEDLINE was performed for English-spoken articles published from January 2002 to December 2012. Keywords used were upper GI series, RYGB, and obesity. Only cases of anastomotic leaks were considered. A total of 22 studies have been evaluated, 15 recommended a selective use of postoperative UGIS. No differences in leakage detection or in clinical benefit between routine and selective approaches were found. Tachycardia and respiratory distress represent the best criteria to perform UGIS for early diagnosis of anastomotic leak after a RYGB.
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Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292(14):1724–37.
Schiesser M, Guber J, Wildi S, et al. Utility of routine versus selective upper gastrointestinal series to detect anastomotic leaks after laparoscopic gastric bypass. Obes Surg. 2011;21(8):1238–42.
Sjostrom L, Narbro K, Sjostrom CD, et al. Effects of bariatric surgery on mortality in Swedish obese subjects. N Engl J Med. 2007;357(8):741–52.
Gonzalez R, Sarr MG, Smith CD, et al. Diagnosis and contemporary management of anastomotic leaks after gastric bypass for obesity. J Am Coll Surg. 2007;204(1):47–55.
Leslie DB, Dorman RB, Anderson J, et al. Routine upper gastrointestinal imaging is superior to clinical signs for detecting gastrojejunal leak after laparoscopic Roux-en-Y gastric bypass. J Am Coll Surg. 2012;214(2):208–13.
Brockmeyer JR, Simon TE, Jacob RK, et al. Upper gastrointestinal swallow study following bariatric surgery: institutional review and review of the literature. Obes Surg. 2012;22(7):1039–43.
Madan AK, Stoecklein HH, Ternovits CA, et al. Predictive value of upper gastrointestinal studies versus clinical signs for gastrointestinal leaks after laparoscopic gastric bypass. Surg Endosc. 2007;21(2):194–6.
Hamilton EC, Sims TL, Hamilton TT, et al. Clinical predictors of leak after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Surg Endosc. 2003;17(5):679–84.
Sims TL, Mullican MA, Hamilton EC, et al. Routine upper gastrointestinal Gastrografin swallow after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2003;13(1):66–72.
Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000;232(4):515–29.
Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y- 500 patients: technique and results, with 3–60 month follow-up. Obes Surg. 2000;10(3):233–9.
Serafini F, Anderson W, Ghassemi P, et al. The utility of contrast studies and drains in the management of patients after Roux-en-Y gastric bypass. Obes Surg. 2002;12(1):34–8.
Carter JT, Tafreshian S, Campos GM, et al. Routine upper GI series after gastric bypass does not reliably identify anastomotic leaks or predict stricture formation. Surg Endosc. 2007;21(12):2172–7.
Csendes A, Burgos AM, Braghetto I. Classification and management of leaks after gastric bypass for patients with morbid obesity: a prospective study of 60 patients. Obes Surg. 2012;22(6):855–62.
Kolakowski Jr S, Kirkland ML, Schuricht AL. Routine postoperative upper gastrointestinal series after Roux-en-Y gastric bypass: determination of whether it is necessary. Arch Surg. 2007;142(10):930–4. discussion 934.
Lee S, Carmody B, Wolfe L, et al. Effect of location and speed of diagnosis on anastomotic leak outcomes in 3828 gastric bypass cases. J Gastrointest Surg. 2007;11(6):708–13.
Singh R, Fisher BL. Sensitivity and specificity of postoperative upper GI series following gastric bypass. Obes Surg. 2003;13(1):73–5.
Lee SD, Khouzam MN, Kellum JM, et al. Selective, versus routine, upper gastrointestinal series leads to equal morbidity and reduced hospital stay in laparoscopic gastric bypass patients. Surg Obes Relat Dis. 2007;3(4):413–6.
Lyass S, Khalili TM, Cunneen S, et al. Radiological studies after laparoscopic Roux-en-Y gastric bypass: routine or selective? Am Surg. 2004;70(10):918–21.
Raman R, Raman B, Raman P, et al. Abnormal findings on routine upper GI series following laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17(3):311–6.
Dallal RM, Bailey L, Nahmias N. Back to basics—clinical diagnosis in bariatric surgery. Routine drains and upper GI series are unnecessary. Surg Endosc. 2007;21(12):2268–71.
Katasani VG, Leeth RR, Tishler DS, et al. Water-soluble upper GI based on clinical findings is reliable to detect anastomotic leaks after laparoscopic gastric bypass. Am Surg. 2005;71(11):916–8. discussion 918-9.
White S, Han SH, Lewis C, et al. Selective approach to use of upper gastroesophageal imaging study after laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(2):122–5.
Csendes A, Burdiles P, Jensen C, et al. Preliminary results of horizontal gastroplasty with Roux in Y anastomosis in patients with severe and morbid obesity. Rev Med Chil. 1999;127(8):953–60.
Doraiswamy A, Rasmussen JJ, Pierce J, et al. The utility of routine postoperative upper GI series following laparoscopic gastric bypass. Surg Endosc. 2007;21(12):2159–62.
Esmailzadeh H, Powell W, Lourie D. Use of computed tomography in diagnosis of major postoperative gastrointestinal complications of laparoscopic Roux-en-Y gastric bypass surgery. Am Surg. 2004;70(11):964–6.
McCarty TM, Arnold DT, Lamont JP, et al. Optimizing outcomes in bariatric surgery: outpatient laparoscopic gastric bypass. Ann Surg. 2005;242(4):494–8. discussion 498-501.
Karanikas ID, Kakoulidis DD, Gouvas ZT, et al. Barium peritonitis: a rare complication of upper gastrointestinal contrast investigation. Postgrad Med J. 1997;73(859):297–8.
Bertucci W, White S, Yadegar J, et al. Routine postoperative upper gastroesophageal imaging is unnecessary after laparoscopic Roux-en-Y gastric bypass. Am Surg. 2006;72(10):862–4.
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Quartararo, G., Facchiano, E., Scaringi, S. et al. Upper Gastrointestinal Series after Roux-en-Y Gastric Bypass for Morbid Obesity: Effectiveness in Leakage Detection. a Systematic Review of the Literature. OBES SURG 24, 1096–1101 (2014). https://doi.org/10.1007/s11695-014-1263-5
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DOI: https://doi.org/10.1007/s11695-014-1263-5