Computed tomography scan versus upper gastrointestinal fluoroscopy for diagnosis of staple line leak following bariatric surgery

Jason Bingham*, Robert Shawhan, Ross Parker, Jay Wigboldy, Vance Sohn

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

29 Scopus citations

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.

Original languageEnglish
Pages (from-to)810-814
Number of pages5
JournalAmerican Journal of Surgery
Volume209
Issue number5
DOIs
StatePublished - 1 May 2015

Keywords

  • Anastomotic leak
  • Bariatric surgery
  • Computed tomography
  • Upper GI fluoroscopy

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