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Usefulness of Clinical Signs and Diagnostic Tests for Suspected Leaks in Bariatric Surgery

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An Erratum to this article was published on 13 March 2015

Abstract

Background

The early diagnosis of leakage poses a challenge to bariatric surgeons, who need to suspect and treat it promptly. The aim of this study is to determine the value of clinical signs and complementary tests in its detection.

Methods

Between January 2007 and 2012, 200 patients underwent surgery for pathological obesity. Perioperative variables were collected prospectively, and univariate and multivariate analyses were conducted to study the factors related to leak occurrence and the predictive value of the tests performed.

Results

The study includes 172 proximal gastric bypasses and 28 sleeve gastrectomies. Nine patients (4.5 %) had leaks in the immediate postoperative period. Multivariate analyses found that age over 48 years and preoperative BMI > 48 kg/m2 were the patient-related variables associated with a higher risk of leakage. The clinical variables significantly related to postoperative leaks were heart rate over 100 bpm, leukocytes over 15,000/mm3 and systolic arterial pressure below 100 mmHg. In patients with a clinical suspicion of leakage (n = 19), 15 % of abdominal CT scans returned false negatives, versus 28.6 % for oral methylene blue and 33.3 % for upper gastrointestinal (UGI) Gastrografin swallow.

Conclusions

Bariatric surgery proved to be a safe technique at our medical centre. Patient-related variables associated with a higher risk of leakage were age and BMI. Early clinical signs of leakage were tachycardia, leukocytosis and hypotension. The most reliable diagnostic test was the abdominal CT scan.

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Statement of Informed Consent

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

Statement of 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.

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Authors and Affiliations

  1. Department of Surgery, University Hospital of Canaries (HUC), Santa Cruz de Tenerife, Spain

    I. Arteaga-González, A. Martín-Malagón, J. Martín-Pérez & A. Carrillo-Pallarés

  2. Secretaría del Departamento de Cirugía (7a planta), Hospital Universitario de Canarias, C/ Ofra, s/n. La Cuesta, La Laguna, Tenerife, CP 38320, Spain

    J. Martín-Pérez

Authors
  1. I. Arteaga-González
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  2. A. Martín-Malagón
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  3. J. Martín-Pérez
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  4. A. Carrillo-Pallarés
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Corresponding author

Correspondence to J. Martín-Pérez.

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Arteaga-González, I., Martín-Malagón, A., Martín-Pérez, J. et al. Usefulness of Clinical Signs and Diagnostic Tests for Suspected Leaks in Bariatric Surgery. OBES SURG 25, 1680–1684 (2015). https://doi.org/10.1007/s11695-015-1589-7

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  • DOI: https://doi.org/10.1007/s11695-015-1589-7

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