• Anastomotic leakage
• Gastric cancer
• Gastroscopy
• Leakage testing
• Total gastrectomy

• Humans
• Anastomosis, Surgical/adverse effects
• Anastomotic Leak/epidemiology
• Anastomotic Leak/etiology
• Anastomotic Leak/prevention & control
• Constriction, Pathologic/surgery
• Gastrectomy/adverse effects
• Gastrectomy/methods
• Laparoscopy/adverse effects
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Postoperative Complications/prevention & control
• Prospective Studies
• Retrospective Studies
• Stomach Neoplasms/surgery
• Stomach Neoplasms/complications

Many imaging methods such as ultrasonography, computed tomography (CT), magnetic resonance imaging, and endoscopy are used to identify the problems or complications that occur in the perioperative period and to determine the appropriate therapeutic approach. Specialists at surgical clinics and intensive care units sometimes need diagnostic procedures that can give quick results or reveal unexpected results. In particular, rapid on-site evaluation of patients followed under intensive care conditions has several advantages.

To determine the problems developing in patients in the perioperative period by contrast-enhanced abdominal X-ray (CE-AXR), revealing their current status or defining the effectiveness of CE-AXR.

The files of the patients who underwent hepatopancreatobiliary or upper gastrointestinal surgery, whose CE-AXR film was taken, were reviewed retrospectively. Abdominal X-ray radiographs taken after ingestion of a water-soluble contrast agent (iohexol, 300 mg, 50 cc vial) and its application in a drain, nasogastric tube, or stent were evaluated. The contribution of the data obtained in patients who underwent CE-AXR to the diagnosis, follow-up, and treatment processes and the effectiveness of the application were investigated.

CE-AXR was applied to 131 patients in our clinic, most of whom underwent hepatopancreatobiliary or upper gastrointestinal surgery. It was determined that the data obtained from CE-AXR films taken in 98 (74.8%) of the patients contributed to the diagnosis, treatment, and follow-up expectations and positively affected the clinical processes.

CE-AXR is a simple procedure that can be applied anywhere, especially in intensive care patients and at bedside, with a portable X-ray device. The simplicity of the procedure, less radiation exposure for the patients, less time wastage, reduction in the CT and endoscopy procedure burden and costs, quick results, rapid assessment of the situation, and enabling the monitoring of processes with repetitive procedures are important advantages. X-rays taken will be useful in terms of being a reference value during the follow-up period of the patient and determining the situation in medicolegal processes.

• Abdominal X-rays
• Contrast medium
• Diagnosis
• Complication
• Leakage
• Radiation exposure

• bariatric surgery
• laparoscopic sleeve gastrectomy
• revisional surgery

• No funding

Laparoscopic Roux-en-Y gastric bypass (LRYGB) and sleeve gastrectomy (SG) are the two most common bariatric operations. With the implementation of enhanced recovery protocols, the use of drains should decrease.

The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database was queried for the years 2015–2017. Our inclusion criteria included all patients undergoing a primary LRYGB, SG, and revisions. We examined demographics, operative characteristics, the use of drains, and postoperative complications. Continuous variables were summarized using means and standard deviations (SD). Categorical variables were summarized using frequencies and proportions. Student’s T test (Wilcoxon sum rank test in the case of skewed data) and chi-squared analysis were used to assess the baseline differences in drain utilization.

From 2015 to 2017, there were 388,239 bariatric cases performed without drains and 100,221 performed with drains. Twenty-nine percent of LRYGB patients had a drain placed but only 16.7% of SG patients. The percentage of LRYGB that had a drain dropped from 33.1 to 24.6% during the study period and that of SG dropped from 20.3 to 13.6%. Patients that had drains placed were more likely to have a provocative test at the time of surgery (prevalence ratio (PR) 2.24) and to have a postoperative swallow study (PR 1.93).

Drains are still commonly used in bariatric patients. Over the study period, there was a decrease in the use of drains in both bypass and sleeve patients. Patients with a drain were more likely to have had a provocative test and a swallow study and have a higher rate of complications and mortality.

The online version of this article (10.1007/s11695-019-04215-6) contains supplementary material, which is available to authorized users.

• Abdominal drains
• Bariatric surgery
• MBSAQIP
• Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program

• Accreditation
• Adult
• Bariatric Surgery/methods
• Bariatric Surgery/statistics & numerical data
• Bariatric Surgery/trends
• Databases, Factual
• Drainage/adverse effects
• Drainage/methods
• Drainage/statistics & numerical data
• Drainage/trends
• Female
• Humans
• Laparoscopy/methods
• Laparoscopy/statistics & numerical data
• Laparoscopy/trends
• Male
• Middle Aged
• Obesity, Morbid/epidemiology
• Obesity, Morbid/surgery
• Postoperative Complications/epidemiology
• Postoperative Complications/etiology
• Prevalence
• Quality Improvement
• Treatment Outcome