The Workup for Bariatric Surgery Does Not Require a Routine Upper Gastrointestinal Series |
| |
Authors: | Andrew J Ghassemian Kenneth G MacDonald MD Paul G Cunningham MD Melvin Swanson PhD Brenda M Brown MRA Patricia G Morris BSN Walter J Pories MD |
| |
Institution: | (1) The Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina, 27858, USA;(2) The Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina, 27858, USA;(3) The Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina, 27858, USA;(4) The Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina, 27858, USA;(5) The Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina, 27858, USA;(6) The Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina, 27858, USA;(7) The Department of Surgery, East Carolina University School of Medicine, Greenville, North Carolina, 27858, USA |
| |
Abstract: | Background: Morbid obesity is a serious disease that afflicts over five million Americans, threatening their health with such
co-morbidities as diabetes, arthritis, pulmonary failure and stroke. Surgery is the only effective therapy, providing long-term
control of weight, diabetes, pulmonary failure, and hypertension for as long as 14 years. Because the operation presents a
major expense, this study examined whether X-ray examination of the gut could be omitted safely as a cost-saving measure.
Methods: The records of 814 consecutive morbidly obese patients who underwent gastric bypass were reviewed to determine: (1)
whether these individuals had undergone an upper gastro-intestinal (GI) series, and (2) if these studies influenced therapy
or caused cancellation or postponement of surgery. Results: Of the 814 patients, 657 (80.7%) underwent a preoperative GI radiography.
Of these examinations, 393 (59.8%) were normal, with the following abnormalities in the remaining 264: hiatal hernia, 164;
esophageal reflux, 39; Schatzki's ring, 18; small bowel diverticula, four; renal stones, four; malrotation, three; gall stones,
two; pyloric ulcer, one; possible pelvic mass, one; calcified leiomyoma, one; and dysphagial lusoria, one. None of these findings
resulted in cancellation or a delay in surgery. Conclusions: The upper GI series can be safely omitted from the routine preoperative
evaluation of patients undergoing gastric bypass. At a cost of $741.00 per examination, this change represents significant
potential savings. Similar evaluations of other routine preoperative tests may well provide a better basis for the evaluation
of these complex patients. |
| |
Keywords: | Gastric bypass gastro-intestinal radiography health-care costs morbid obesity |
本文献已被 SpringerLink 等数据库收录! |
|