Abstract
Background
Postoperative upper gastrointestinal series (UGI) has never been shown to be effective
in ruling out leaks or obstruction after gastric bypass or sleeve gastrectomy. In
sleeve gastrectomies, UGI will define the shape of the sleeve and rule out a retained
fundus that was not optimally excised during surgery.
Objectives
We aimed to investigate the impact of a “retained fundus” on weight loss to determine
whether UGIs can be used to gauge success of the operation and predict outcome.
Setting
Urban community teaching hospital, United States.
Methods
Retrospective study analyzing routine UGIs performed on 203 consecutive patients.
Exclusion criteria included low quality UGI (absence of a still image of complete
fill with contrast), revisions from gastric band to sleeve, absence of weight-loss
data, postoperative leak, and postoperative stenosis.
Results
A total of 149 patients were included. Mean excess weight loss at one year for groups
1 through 4 was 67.3%, 72.7%, 67.8%, and 65.9%, respectively. There was no significant
statistical difference in excess weight loss between the optimal group and the group
of both mild and severe retained fundus (P = .22). The weight loss remained equivalent even when comparing the optimal sleeves
with only those with severe retained fundus (P = .19). There was a statistically significant difference in quality of sleeve gastrectomies
on UGI with surgical experience showing less retained fundus on the UGIs (P = .006) in the latter half of the series.
Conclusion
Retained fundus does not seem to cause inferior weight loss in the early postoperative
period. Thus, UGI cannot predict weight loss outcomes in the short term.
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Article info
Publication history
Published online: January 27, 2017
Accepted:
January 20,
2017
Received:
August 27,
2016
Identification
Copyright
© 2017 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
