196 Are Intra-Operative Leak Tests in Current Bariatric Practice Relevant and Useful?

Abstract Aim In the light of conflicting published views on usefulness of intraoperative leak tests we studied our own practice of routine of intraoperative leak tests. Method 510 patients comprising of primary and revision procedures who had been followed for at least 4-5 years were analysed in two independent phases of 6 months to remove incidental pattern. 287 were primary procedures and 123 were revisions.All patients had intraoperative Gastrografin and air leak test on table followed with gastrografin swallow/meal the next morning or later same day. As a policy, if any doubt, we had a low threshold for CT scan especially in revision group. OSMR was recorded in all the patients in this study. Fully informed consent with written and verbal information recorded. Appropriate Dietetic and psychological assessment was done. We provided Nurse specialist and Dietician support for all patients and planned follow up for five years. Results Age ranged from 23 years to 76 years. Average OSMR was 2.46. Average BMI in GBP was 52.4 and LSG was 66. of the primary cases 261 were GBP rest LSG (126/387). Her was one positive intraoperative leak test (0.25%) in primary group (GBP) that was remedied on table followed with normal Gastrografin test next morning and patient was discharged as per usual protocol. There were three positive leak tests in revision group (2.3%). There was one iatrogenic jejuna injury in revision group picked up on CT. Conclusions We found that leak tests 'prevented' symptomatic leaks. The policy of leak tests and contrast swallow is worthwhile.