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Routine Upper Gastrointestinal Series Post-bariatric Surgery: Predictors, Usage, and Utility

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Abstract

Objective

To investigate usage and utility of routine upper gastrointestinal (UGI) series in the immediate post-operative period to evaluate for leak and other complications.

Methods

Single institution IRB-approved retrospective review of patients who underwent bariatric procedure between 01/08 and 12/12 with at least 6-month follow-up.

Results

Out of 135 patients (23%) who underwent routine UGI imaging, 32% of patients were post-gastric bypass (127) versus 4% of sleeve gastrectomy (8). In patients post-gastric bypass, 22 were found with delayed contrast passage, 3 possible obstruction, 4 possible leak, and only 1 definite leak. In patients post-sleeve gastrectomy, 2 had delayed passage of contrast without evidence of a leak. No leak was identified in 443 patients (77%) who did not undergo imaging. The sensitivity and specificity of UGI series for the detection of leak in gastric bypass patients were 100% and 97%, respectively, and the positive and negative predictive values were 20% and 100%, respectively. On univariate and multivariate analysis, sleeve gastrectomy patients (OR 0.4 sleeve vs bypass; P < 0.01) and male patients (OR 0.4 M vs F; P 0.02) were less likely to undergo routine UGI series (OR 0.4 M vs F; P 0.02).

Conclusion

Routine UGI series may be of limited value for the detection of anastomotic leaks after gastric bypass or sleeve gastrectomy and patients should undergo routine imaging based on clinical parameters. Gastric bypass procedure and female gender were factors increasing the likelihood of routine post-operative UGI. Further larger scale analysis of this important topic is warranted.

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Author information

Authors and Affiliations

  1. Department of Radiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA

    Ketan Dayma

  2. Department of Radiology, Harlem Hospital Center, New York, NY, 10037, USA

    Aruna David, Adil Omer, Haneen Abdel-Dayam, Leaque Ahmed, Anthony Gilet & Dana Haddad

  3. Department of Surgery, Harlem Hospital Center, New York, NY, 10037, USA

    Anan Tawil

  4. Department of Bioinformatics, Memorial Sloan-Kettering Cancer Center, New York, NY, 10021, USA

    Nicholas Socci

  5. Department of Radiology, Westchester Medical Center, Westchester, NY, 10595, USA

    Anthony Gilet

  6. School of Medicine, Mohammed Bin Rashid University, Dubai, United Arab Emirates

    Dana Haddad

Authors
  1. Ketan Dayma
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  2. Aruna David
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  9. Dana Haddad
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Corresponding author

Correspondence to Dana Haddad.

Ethics declarations

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

IRB Statement

This study was approved by the Biomedical Research Alliance of New York.

Conflict of Interest

The authors declare no competing interests.

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Highlights

This study determines the utility of routine UGI series for the detection of anastomotic leaks after gastric bypass or sleeve gastrectomy. It suggests patients should undergo imaging based on clinical parameters rather than routine use of post-operative imaging. Gastric bypass procedure and female gender were the factors increasing the likelihood of routine post-operative UGI.

Key Points

• Routine upper gastrointestinal (UGI) series is often utilized in the immediate post-operative period to evaluate for leak and other complications.

• However, based on our study, routine UGI may be of limited value for detection of anastomotic leaks after bariatric procedure and patients should undergo routine imaging based on clinical parameters.

• Gastric bypass procedure and female gender were factors increasing the likelihood of routine post-operative UGI.

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Dayma, K., David, A., Omer, A. et al. Routine Upper Gastrointestinal Series Post-bariatric Surgery: Predictors, Usage, and Utility. OBES SURG 34, 1552–1560 (2024). https://doi.org/10.1007/s11695-024-07125-4

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  • DOI: https://doi.org/10.1007/s11695-024-07125-4

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