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肥胖症手术后早期常规上消化道造影检查:是不可或缺的术后护理还是医疗法律遗产?

Early Routine Upper Gastrointestinal Contrast Study Following Bariatric Surgery: an Indispensable Postoperative Care or a Medicolegal Heritage?

机构信息

U.O.C. Chirurgia Endocrina e Metabolica, Fondazione Policlinico Universitario A Gemelli IRCCS, L.go A. Gemelli 8, 00168, Rome, Italy.

Istituto di Semeiotica Chirurgica, Università Cattolica del Sacro Cuore, L.go A. Gemelli 8, Rome, 00168, Italy.

出版信息

Obes Surg. 2019 Jun;29(6):1995-1998. doi: 10.1007/s11695-019-03850-3.

Abstract

Concerns still exist regarding the role of early routine upper gastrointestinal contrast study (UGI) after bariatric procedures for detection of early complications. We reviewed our database to identify patients who underwent laparoscopic primary or redo surgery (previously placement of adjustable gastric banding), between January 2012 and December 2017. All the patients underwent UGI within 48 h after surgery. Among 1094 patients, early UGI was abnormal in 5 patients: in 4 cases a leak (one false positive) and in one case stenosis (one true positive) were suspected. In this clinical setting, five leaks were observed and required surgical re-exploration: 3 correctly identified and 2 not detected at UGI. Overall, 3 patients developed anastomotic stenosis. Our data suggest that early routine UGI after bariatric procedures has limited utility.

摘要

对于肥胖症手术后早期常规上消化道对比研究(UGI)在早期并发症检测中的作用仍存在担忧。我们回顾了数据库,以确定 2012 年 1 月至 2017 年 12 月期间接受腹腔镜初次或再次手术(先前放置可调节胃束带)的患者。所有患者均在手术后 48 小时内进行 UGI 检查。在 1094 名患者中,有 5 名患者的早期 UGI 异常:在 4 例中怀疑存在漏(1 例假阳性)和在 1 例中怀疑存在狭窄(1 例真阳性)。在这种临床情况下,观察到 5 例漏,需要再次手术探查:3 例在 UGI 检查中正确识别,2 例未检测到。总体而言,有 3 名患者发生吻合口狭窄。我们的数据表明,肥胖症手术后早期常规进行 UGI 检查的作用有限。

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