Bariatric patients are difficult to assess clinically for signs of postoperative complication. Diagnostic laparoscopy (DL) is used to investigate patients suspicious for complications such as anastomotic leak (AL) and intra-abdominal hemorrhage (IH). Most bariatric surgeons use DL in the presence of sustained tachycardia; however, the rate of this procedure and its clinical value have not been sufficiently investigated.A retrospective review of patients undergoing bariatric surgery from January 2010 to December 2011 was performed. Data from 4 collaborative bariatric centres of excellence were included in this analysis. From among all elective bariatric procedures, cases that required early reoperation were selected for further evaluation.A total of 1001 elective bariatric procedures were identified. Of these, 952 (95%) were primary bariatric procedures, including 866 (91%) Roux-en-Y gastric bypasses and 86 (9%) sleeve gastrectomies. The remaining 48 cases represented revisional proced ures. Of these, 11 patients (1.1%) returned to the operating room within 72 hours for DL: 64% were primary cases (n = 7) and 36% revisional cases (n = 4). Intraoperative findings included AL (45%, n = 5), IH (27%, n = 3), no pathology identified (18%, n = 2) and small bowel obstruction (9%, n = 1). Of the 9 patients with complications, all were tachycardic (heart rate > 100 beats/min), and 4 of the 5 patients with AL were febrile (t > 37.5). There were no reported adverse events directly related to the use of DL.Diagnostic laparoscopy is a useful and safe option for both the diagnosis and treatment of suspected complications after bariatric surgery. The majority of patients returning to operating room had significant findings, and all were treated laparoscopically. Persistent postoperative tachycardia or fever were highly predictive of positive findings during DL. An emphasis on early decisionmaking and expeditious return to the operating room for laparoscopy should be the standard for bariatric patients on clinical suspicion of a postoperative complication. 4Changes of active and total ghrelin, GLP-1 and PYY following restrictive bariatric surgery and their impact on satiety: comparison of sleeve gastrectomy and adjustable gastric banding. A

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patients with non-surgical stage disease (n¼10); 2) imprinted cytological samples from positive mediastinoscopies during the intraoperative staging of patients with lung cancer (n¼11); 3) positive pleural fluid in patients with pulmonary nodule (n¼2). Then we performed FISH technique, evaluated the quality of the signal obtained, and compared the results with those obtained on paraffin sections. FISH technique on paraffin blocks was performed using 2XSSC/ proteinase K pretreatment as standardized by our lab. Cytology smears were destained and fixed in 10% methanol and incubated with FISH probe (ALK, ROS1 and MET). Result: All cytology cases had scorable signals and were easy to interpret. Also, as no pretreatment was required, assay time was shorter. Depending on cellularity, one same slide was useful for analysis of the three probes. When comparing with IHC and FISH studies, we obtained a 100% correlation with ALK (n¼23; positive¼2, negative¼21), ROS1 (n¼5, all negative) and MET (n¼5, all negative). Conclusion: This work allowed us to optimize the use of different cytology samples frequently available in advance stage NSCLC for FISH studies. The use of cytological material might improve turnaround time for results and can become a useful tool in pathology labs, in particular when paraffin included material is limited.

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