Upper Gastrointestinal Studies After Laparoscopic Sleeve Gastrectomy: A Study that Prolongs Length of Stay

作者：Tholey Renee M; Abelson Jonathan S; Hassen Sara; Benhuri Daniel; Zarnegar Rasa; Dakin Gregory; Pomp Alfons; Afaneh Cheguevara^*

来源：Bariatric Surgical Practice and Patient Care, 2017, 12(1): 21-24.

DOI：10.1089/bari.2016.0032

• sleeve gastrectomy
• obesity
• morbid obesity
• length of stay
• upper GI series

Background and Objectives: Laparoscopic sleeve gastrectomy (LSG) has become a common bariatric procedure performed in the United States. The purpose of our study was to determine factors affecting length of stay (LOS) after LSG in a University Hospital in the United States.
Methods: One hundred eighty-seven patients underwent LSG over two 6-month periods in 2013 and 2014. Patients were selected by their surgeon to undergo a routine upper gastrointestinal (UGI) study (UGI group) or to proceed directly to a liquid diet (No UGI group). Primary endpoint was LOS. Secondary endpoint was surgical morbidity. One hundred thirty-four patients were in the UGI group and 53 patients were in the No UGI group.
Results: Postoperative complications were 8% in the UGI group and 4% in the No UGI group (p = 0.28). There were no leaks and no significant difference in 90-day readmission rates (p = 0.44). LOS was 58.9 h in the UGI group and 51.4 h in the No UGI group (p = 0.009). Multivariate logistic regression analysis was used to identify independent predictors of an LOS > 48 h. Performing a postoperative UGI study was the strongest predictor of an LOS > 48 h with an odds ratio (OR) of 1.524 (p = 0.01) followed by increasing American Society of Anesthesiology (ASA) score (OR= 2.18, p = 0.03).
Conclusions: Patients undergoing a postoperative UGI study are more likely to have an increased LOS than patients in the No UGI group with no difference in surgical morbidity, leak rate, or readmission rate. Eliminating routine UGI studies after LSG is an effective strategy to decrease LOS.

• 出版日期2017-3