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Surgical Endoscopy

Published in:

01-09-2010

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

Authors: Noelle L. Bertelson, Jonathan A. Myers

Published in: Surgical Endoscopy | Issue 9/2010

Abstract

Background

Laparoscopic adjustable gastric banding (LAGB) has become an accepted procedure for weight loss surgery, particularly due to fewer early complications and decreased mortality in comparison to other bariatric procedures. Many centers use postoperative upper gastrointestinal fluoroscopy (UGI) to ensure stomal patency and gastric integrity at the banding site. However, UGI increases cost and may increase length of stay due to availability. The purpose of this study is to determine whether routine UGI after LAGB is necessary for detection of early complications.

Methods

A prospective database of 200 LAGBs performed by a single surgeon over 3 years was reviewed retrospectively. All patients underwent UGI 2–24 h after surgery.

Results

Mean age was 43, mean BMI was 45, and mean operative time was 44 min. Forty-four percent of patients stayed overnight. All postoperative UGI results were normal. Six percent underwent intraoperative instillation of methylene blue due to procedural difficulty with no leaks identified. These patients on average were 5 years older (p < 0.01) and had an operative time 23 min longer (p < 0.01). Differences in gender and BMI were not statistically significant. One patient (0.5%), who had a normal methylene blue test and normal UGI, returned within 2 days with a gastric perforation requiring band explant and gastric repair.

Conclusions

We conclude that routine UGI after LAGB is not necessary based on a 0% stomal obstruction rate and detection of not a single gastric leak. Elimination of routine postoperative UGI will decrease cost and length of hospital stay. We suggest a selective approach for those patients at increased risk of early postoperative complications, including those having intraoperative methylene blue instillation, increased length of operation, and increased age.

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Title: Routine postoperative upper gastrointestinal fluoroscopy is unnecessary after laparoscopic adjustable gastric band placement
Authors: Noelle L. Bertelson
Jonathan A. Myers
Publication date: 01-09-2010
Publisher: Springer-Verlag
Published in: Surgical Endoscopy / Issue 9/2010
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-010-0924-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

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

Abstract

Background

Methods

Results

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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