Jason Bingham1, Robert Shawhan2, Ross Parker2, Jay Wigboldy2, Vance Sohn2. 1. Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA. Electronic address: jason.r.bingham4.mil@mail.mil. 2. Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA.
Abstract
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: CT is a superior modality compared with UGI for detecting staple line leaks following bariatric surgery. Published by Elsevier Inc.
BACKGROUND: 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. METHODS: 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. RESULTS: 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). CONCLUSION: CT is a superior modality compared with UGI for detecting staple line leaks following bariatric surgery. Published by Elsevier Inc.
Entities:
Keywords:
Anastomotic leak; Bariatric surgery; Computed tomography; Upper GI fluoroscopy
Authors: Jakob Weiss; Andreas Pomschar; Carsten Rist; Klement Neumaier; Minglun Li; Wilhelm Flatz; Kolja Thierfelder; Mike Notohamiprodjo Journal: Radiol Med Date: 2017-07-22 Impact factor: 3.469
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