Matthew J Lyon, MD1, Victoria Hall2, Kamal Heer, MD3, Harish Kumar, MD1. 1University of Queensland, 2University of Perth, 3Monash University
Introduction: There is a long-standing practice of testing anastamosis both in upper and Lower GI surgery. Post-operative leaks in bariatric surgery are an uncommon but serious compilation increasing morbidity and risk of mortality. The present study looks at the practice of performing an intra-operative leak test during roux-en-y gastric bypass(RYGB) and Sleeve Gastrectomy(SG).
Methods and Procedures: The study was divided in two independent phases of six months and 12 months. Data was collected from all patients undergoing SG, RYGB or revision RYGB within those two periods. To confirm the integrity of the staple line all patients underwent a methylene blue and air test Intra-operatively. This was followed by a gastrograffin swallow the morning post procedure.
Results: Total number of patients in the study was 219.There were four positive intraoperative tests. One patient was a primary RYGB and three patients were undergoing revision RYGB. All were reinforced and subsequent recovery and gastrograffin swallow showed no leak. One revision RYGB had an undetected small bowel injury distal to jejuno-jejunostomy that was not identified on intraoperative or next day imaging.
Conclusion: There is little evidence in the literature showing the clinical benefit of intra-operative leak test with bariatric surgery. Our study identified four leaks intra-operatively, all in patients undergoing RYGB. Our study highlights the practice of intra-operative leak testing especially in RYGB may have clinical benefit.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 87680
Program Number: P571
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster