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

Autor: Bingham J; Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA. Electronic address: jason.r.bingham4.mil@mail.mil., Shawhan R; Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA., Parker R; Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA., Wigboldy J; Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA., Sohn V; Department of General Surgery, Madigan Army Medical Center, 9040 Fitzsimmons Drive, Tacoma, WA 98431, USA.
Jazyk: angličtina
Zdroj: American journal of surgery [Am J Surg] 2015 May; Vol. 209 (5), pp. 810-4; discussion 814. Date of Electronic Publication: 2015 Feb 14.
DOI: 10.1016/j.amjsurg.2015.01.004
Abstrakt: 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.)
Databáze: MEDLINE
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