Routine upper gastrointestinal gastrografin® swallow after laparoscopic Roux-en-Y gastric bypass

Thomas L. Sims, Mary A. Mullican, Elizabeth C. Hamilton, David A. Provost, Daniel B. Jones

Research output: Contribution to journalArticle

67 Scopus citations

Abstract

Background: Upper gastrointestinal (UGI) swallow radiographs following laparoscopic Roux-en-Y gastric bypass (LRYGBP) may detect an obstruction or an anastomotic leak. The aim of our study was to determine the efficacy of routine imaging following LRYGBP. Methods: Radiograph reports were reviewed for 201 consecutive LRYGBP operations between April 1999 and June 2001. UGI swallow used Gastrografin®, static films, fluoroscopic video, and a delayed image at 10 minutes. Mean values with one standard deviation were tested for significance (P<0.05) using the Mann-Whitney U test statistic. Results: Of 198 available reports, UGI detected jejunal efferent (Roux) limb narrowing (n=17), partial obstruction (n=12), anastomotic leak (n=3), complete bowel obstruction (n=3), diverticulum (n=1), hiatal hernia (n=1), and proximal Roux limb narrowing (n=1). A normal study was reported in 160 cases (81%). Partial obstruction resolved without intervention. Complete obstruction required re-operation. Compared to 6 patients who developed delayed leaks, early identification of a leak by routine UGI swallow resulted in a shorter hospital stay (mean 7.7±1.5 days vs 40.2±12.3 days, P<0.03). Conclusions: Early intervention after UGI swallow may lessen morbidity. Routine UGI swallow following LRYGBP does not obviate the importance of close clinical follow-up.

Original languageEnglish (US)
Pages (from-to)66-72
Number of pages7
JournalObesity Surgery
Volume13
Issue number1
DOIs
StatePublished - Feb 1 2003

Keywords

  • Bariatric surgery
  • Gastric bypass
  • Gastrografin®
  • Laparoscopy
  • Leak
  • Morbid obesity
  • Postoperative complications
  • Roux-en-Y

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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