Routine Upper Gastrointestinal Fluoroscopy Before Laparoscopic Sleeve Gastrectomy: Is It Necessary?

Obesity Surgery
Ido MizrahiNaama Lev Cohain

Abstract

Controversy exists regarding the clinical utility of routine preoperative upper gastrointestinal (GI) fluoroscopy in morbid obese patients undergoing laparoscopic sleeve gastrectomy (LSG). The aim of our study was to determine the efficacy of these studies in detecting hiatal hernias (HH). The institution's prospectively maintained, IRB-approved database was retrospectively queried to identify all consecutive patients who underwent LSG between 2011 and 2017. All patients underwent routine preoperative upper GI fluoroscopy. Reports from all imaging studies were retrospectively reviewed and compared to the presence of an intraoperative HH. During the study period, a total of 1810 patients (854 males, 956 females) underwent LSG at our institution. Mean age was 40.95 ± 13 years (range 11-75), and mean BMI was 42.8 ± 5 kg/m2 (range 30-86). The overall prevalence of HH was 11.1% (201 patients). All HHs detected were repaired. Considering the intraoperative identification of HH the gold standard for diagnosis, the sensitivity and specificity of preoperative UGI fluoroscopy for HH detection were 32% (66/201) and 94% (1512/1609), respectively. The median operative time was significantly longer when concomitant LSG and HH repair was perf...Continue Reading

References

Jan 18, 2012·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Raul J RosenthalNatan Zundel
Aug 8, 2012·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Emanuele SoricelliNicola Basso
Jul 3, 2013·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Fredrick CheNinh T Nguyen
Nov 12, 2013·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·David V PhamFrank J Borao
Oct 29, 2014·Obesity Surgery·Kamal K MahawarPeter K Small
May 15, 2016·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Michel GagnerRaul Rosenthal
Jun 21, 2016·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·Sean BennettAmy Neville
Sep 19, 2016·Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery·David GoiteinAsnat Raziel

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