Anastomotic Leaks after Laparoscopic Gastric Bypass

Abstract

The gastrojejunostomy may be the most technically challenging step when performing laparoscopic Roux-en-Y gastric bypass. Patients who develop anastomotic leaks have increased morbidity and mortality rates. Difficulty in diagnosis is related to nonspecific systemic symptoms and limitations in most radiological studies. Our aim is to evaluate the incidence, etiology, diagnosis, management, and prevention of anastomotic leaks occurring in patients undergoing laparoscopic Roux-en-Y gastric bypass.

Decreasing anastomotic and staple line leaks after laparoscopic Roux-en-Y gastric bypass

“…ASL after LRYGB is typically attributed to technical error or ischemia [2,11,12,14,20,21]. Although most ASL occur 5-7 days after surgery and are thought to be related to ischemia, 95% of ASL that occur within 2 days of surgery probably result from technical error [2].…”

Standardization of the fully stapled laparoscopic Roux-en-Y gastric bypass for obesity reduces early immediate postoperative morbidity and mortality: A single center study on 2,606 patients

“…One must fear postoperative leaks as the most important cause of surgical related mortality. Gastric or intestinal leaks can and surgeon experience are all associated with poor operative outcome and a greater leakage rate [19,20]. The most common site for an anastomotic leak is the gastro-jejunostomy [20].…”

Ventilação não invasiva no pós-operatório imediato de derivação gastrojejunal com bypass em Y de Roux

“…The methylene blue test was used for the procedure, as follows: 5 ml of the solution were diluted into 100 ml of saline solution; the solution was then taken orally in portions of 20 ml every 20 minutes until the solution was finished. The result was assessed by the abdominal cavity drain tube, which was placed next to the gastrojejunal anastomosis 22 . The chest X-ray was performed during the third PO period.…”