Is intraoperative leak test required in laparoscopic sleeve gastrectomy?

Abstract

Objective: To investigate the efficacy of intraoperative leak test (IOLT) by methylene blue to identify the presence of leak during standardised sleeve gastrectomy (SG) procedure. Study Design: Cross-sectional comparative study. Place and Duration of Study: Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkery, between January 2017 and December 2018. Methodology: A total of 226 consecutive sleeve gastrectomised patients, on whom IOLT was not performed, were included in the study, and were named as group 1. In order to compare with these patients, 226 consecutive sleeve gastrectomised patients, on whom IOLT was performed, were named as group 2. The groups were compared for postoperative leak, other complications, and mortality. Results: In group 1, leakage was detected in two patients. Although IOLT was negative in all patients of group 2, leakage was detected in two patients. The leakage rate (1.6%) was similar in both groups. In IOLT group, sensitivity and positive predictive value of IOLT was 0%; and negative predictive value was 99.1%. Conclusion: The routine use of an IOLT did not reduce the incidence of postoperative leak. IOLT should not be routinely performed, rather it would be appropriate for selected patients.