Computed tomography scan versus upper gastrointestinal fluoroscopy for diagnosis of staple line leak following bariatric surgery

American Journal of Surgery
Jason BinghamVance Sohn

Abstract

The best radiographic modality to diagnose staple line leaks following bariatric surgery remains controversial. Two common studies used are upper gastrointestinal (UGI) fluoroscopy and computed tomography (CT). This study sought to determine the better modality in detecting clinically significant postoperative leaks. This retrospective review was performed of patients undergoing imaging for suspected staple line leaks following bariatric surgery. These studies were reinterpreted by 2 radiologists who were blinded to the original findings. Six hundred nineteen radiographic "leak tests" were selectively performed following bariatric procedures at our institution between January 2005 and December 2011. CT was found to have a sensitivity of 95% (95% confidence interval [CI] 81.8 to 99.1) and a specificity of 100% (95% CI 93.1 to 100) in diagnosing postoperative leaks, while UGI demonstrated a sensitivity of 79.4% (95% CI 61.6 to 90.0) and a specificity of 95% (95% CI 85.2 to 98.7). CT is a superior modality compared with UGI for detecting staple line leaks following bariatric surgery.

References

Mar 13, 2003·Obesity Surgery·Ramapreet Singh, Barry L Fisher
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Dec 11, 2007·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Stephen WhiteErik Dutson
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Citations

Feb 26, 2016·Gastrointestinal Endoscopy·Davinderbir PannuPeter V Draganov
May 12, 2017·Abdominal Radiology·Nishant A PatelAshish P Wasnik
Sep 19, 2020·Langenbeck's Archives of Surgery·Anna DupréeStefan Wolter
Oct 20, 2017·Obesity Surgery·Sergio SusmallianAsnat Raziel
Feb 13, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Ashley A Norton-GregoryStephane L Desouches
Nov 26, 2020·Journal of Clinical Gastroenterology·Mihajlo GjeorgjievskiMichel Kahaleh

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