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Abnormal Findings on Routine Upper GI Series following Laparoscopic Roux-en-Y Gastric Bypass

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Background

The use of postoperative upper GI series (UGIS) after laparoscopic Roux-en-Y gastric bypass (LRYGBP) varies among bariatric surgeons. The authors describe the findings and impact of UGIS after LRYGBP.

Methods

From July 2003 to January 2006, 487 patients undergoing primary LRYGBP at a single academic institution had a single-contrast Gastrografin® UGIS performed on the first postoperative day, without complication. Patient and operative demographics were: mean age 43 years, mean BMI 47 kg/m2, female 84%, and laparoscopic 100%.

Results

Of the 487 patients, the UGIS revealed 14 (2.9%) major and 88 (15.2%) minor abnormalities. Among the majorUGIS abnormalities, 6 (1.2%) demonstrated a gastrojejunal anastomotic (GJA) leak, 8 (1.4%) confirmed complete obstruction at the GJA, and 1 (0.2%) disclosed a communication with the bypassed stomach. For the minor UGIS abnormalities, 45 (9.2%) displayed significant delay in contrast passage through the GJA, 23 (5.0%) had evidence of dilated loops of small and/or large bowel, and 6 (1.2%) verified miscellaneous abnormal findings (malrotation, lower esophageal dysmotility, jejunal clots). Patients with UGIS abnormalities necessitated additional procedures, delayed oral intake and/or longer length of stay (LOS).

Conclusions

UGIS on postoperative day 1 is a useful means of evaluating postoperative LRYGBP anatomy and influenced postoperative care.

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Authors and Affiliations

  1. Departments of Surgery and Radiology, Stanford School of Medicine, Stanford, CA, USA

    Raghav Raman MD, Bhargav Raman, Pavithra Raman MD, Stanford Rossiter MD, Myriam J. Curet MD, Robert Mindelzun MD & John M. Morton MD, MPH, FACS

  2. Stanford University Department of Surgery, Stanford, CA, 94305, USA

    John M. Morton MD, MPH, FACS

Authors
  1. Raghav Raman MD
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  2. Bhargav Raman
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  3. Pavithra Raman MD
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  4. Stanford Rossiter MD
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  5. Myriam J. Curet MD
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  6. Robert Mindelzun MD
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  7. John M. Morton MD, MPH, FACS
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Corresponding author

Correspondence to John M. Morton MD, MPH, FACS.

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Raman, R., Raman, B., Raman, P. et al. Abnormal Findings on Routine Upper GI Series following Laparoscopic Roux-en-Y Gastric Bypass. OBES SURG 17, 311–316 (2007). https://doi.org/10.1007/s11695-007-9057-7

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  • DOI: https://doi.org/10.1007/s11695-007-9057-7

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