| Predictive value of upper gastrointestinal studies versus clinical signs for gastrointestinal leaks after laparoscopic gastric bypass. | |
| | |
MedLine Citation:
|
PMID: 17122986 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
BACKGROUND: The utility of routine upper gastrointestinal (UGI) studies after laparoscopic Roux-en-Y gastric bypass (LRYGB) is a matter of great debate. Because the morbidity and mortality rates associated with an unrecognized postoperative leak are high after LRYGB, diagnosis of a postoperative leak earlier would be of benefit. Clinical signs, however, may predict the diagnosis of a postoperative leak more often. This study explored the hypothesis that UGI studies are more predictive than clinical signs for the early diagnosis of a postoperative leak after LRYGB. METHODS: All patients who underwent LRYGB at the authors' institution were included in this study. Charts were reviewed to examine immediate clinical signs (heart rate, temperature, and white blood cell count within the first 24 h), UGI studies, and clinical course. Sensitivity, specificity, positive predictive value, negative predictive value, and efficiency of clinical signs and UGI studies were calculated. RESULTS: This study included 245 patients with a 3% rate of leak. The positive and negative predictive value of UGI studies were 67% and 99%, respectively. Only an elevated white blood count had a better predictive value (100% for negative predictive value). The efficiency of UGI studies (98%) was better than that of heart rate (83%), white blood count (8%), or temperature (95%). CONCLUSIONS: According to our data, UGI studies are the most predictive of an early leak diagnosis. Clinical signs alone may not be as useful in predicting leaks early after laparoscopic gastric bypasses. Routine early postoperative UGI studies are a reasonable approach to predicting leaks after LRYGB. |
| | |
Authors:
|
A K Madan; H H Stoecklein; C A Ternovits; D S Tichansky; J C Phillips |
Related Documents
:
|
16929206 - Obese and nonobese patients: complications of abdominoplasty. 10340776 - Results and complications of laparoscopic adjustable gastric banding: an early and inte... 10757956 - Vitamin d deficiency in the morbidly obese. 3945426 - Abdominoplasty combined with gynecologic surgical procedures. 21136406 - Minimal access coronary artery bypass surgery. 8781916 - Role of ultrasonography in blunt abdominal trauma: a prospective study. |
Publication Detail:
|
Type: Journal Article Date: 2006-11-21 |
Journal Detail:
|
Title: Surgical endoscopy Volume: 21 ISSN: 1432-2218 ISO Abbreviation: Surg Endosc Publication Date: 2007 Feb |
Date Detail:
|
Created Date: 2007-01-12 Completed Date: 2007-02-07 Revised Date: 2008-03-06 |
Medline Journal Info:
|
Nlm Unique ID: 8806653 Medline TA: Surg Endosc Country: Germany |
Other Details:
|
Languages: eng Pagination: 194-6 Citation Subset: IM |
Affiliation:
|
Department of Surgery, University of Tennessee Health Science Center, 956 Court Avenue, Room G210, Memphis, TN 38163, USA. amadan@utmem.edu |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adolescent Adult Aged Anastomosis, Roux-en-Y / adverse effects, methods Body Mass Index Diagnostic Techniques, Digestive System Female Follow-Up Studies Gastric Bypass / adverse effects*, methods* Humans Laparoscopy / adverse effects*, methods Male Middle Aged Obesity, Morbid / diagnosis, mortality, surgery* Postoperative Complications / diagnosis*, mortality Predictive Value of Tests Retrospective Studies Risk Assessment Sensitivity and Specificity Severity of Illness Index Survival Rate Upper Gastrointestinal Tract / physiopathology |
| Comments/Corrections | |
Comment In:
|
Surg Endosc. 2008 Feb;22(2):574
[PMID:
17973171
]
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Laparoscopic feeding jejunostomy in esophagogastric cancer.
Next Document: Is routine sentinel lymph node biopsy indicated in women undergoing contralateral prophylactic maste...