Abnormal Findings on Routine Upper GI Series following Laparoscopic Roux-en-Y Gastric Bypass

Background The use of postoperative upper GI series (UGIS) after laparoscopic Roux-en-Y gastric bypass (LRYGBP) varies among bariatric surgeons. The authors describe the findings and impact of UGIS after LRYGBP. Methods From July 2003 to January 2006, 487 patients undergoing primary LRYGBP at a single academic institution had a single-contrast Gastrografin? UGIS performed on the first postoperative day, without complication. Patient and operative demographics were: mean age 43 years, mean BMI 47 kg/m², female 84%, and laparoscopic 100%. Results Of the 487 patients, the UGIS revealed 14 (2.9%) major and 88 (15.2%) minor abnormalities. Among the majorUGIS abnormalities, 6 (1.2%) demonstrated a gastrojejunal anastomotic (GJA) leak, 8 (1.4%) confirmed complete obstruction at the GJA, and 1 (0.2%) disclosed a communication with the bypassed stomach. For the minor UGIS abnormalities, 45 (9.2%) displayed significant delay in contrast passage through the GJA, 23 (5.0%) had evidence of dilated loops of small and/or large bowel, and 6 (1.2%) verified miscellaneous abnormal findings (malrotation, lower esophageal dysmotility, jejunal clots). Patients with UGIS abnormalities necessitated additional procedures, delayed oral intake and/or longer length of stay (LOS). Conclusions UGIS on postoperative day 1 is a useful means of evaluating postoperative LRYGBP anatomy and influenced postoperative care. Presented at the 11th World Congress of the International Federation for the Surgery of Obesity, Sydney, Australia, August 31, 2006.