Assessing Bleeding Risk in Bariatric Surgeries: A Retrospective Analysis Study

Abstract

Objective: To determine the factors that influence bleeding during the course of bariatric surgeries. Background: Bariatric surgery is safe with a low percentage of complications compared with other abdominal surgeries. Bleeding is one of the most common complications in surgery for obesity that has the risk of being catastrophic. Methods: The study includes 8,544 cases that underwent bariatric surgery from January 2013 to March 2016 retrospectively, in 4 private institutions. Multiple demographic data were collected: patient characteristics, diseases, medications, surgery type, operative technique, devices, surgeon’s skill, and volume. Results: Bleeding was the most frequent complication that occurred in 122 (1.3%) patients. The Gastric bypass had the highest rate of bleeding (3.05%) of which, 20% were intraoperative bleeding and 80% postoperatively (intra-abdominal in 75%, and intra-luminal in 5%). Simultaneous surgeries, revisional surgeries, stratification of body mass index, stapler line reinforcement, and hospital volume did not affect bleeding occurrence. The determining factors for bleeding were hypertension, chronic lung disease, age >45 years, arrhythmia, and surgeon’s skills. Conclusion: Bleeding after bariatric surgery has a low occurrence. The factors that influence the occurrence of perioperative bleeding in bariatric surgery are: hypertension, chronic lung disease, age >45 years, arrhythmia, and surgeon’s skills.

Status of bariatric endoscopy–what does the surgeon need to know? A review

“…In addition to assistance with diagnosis, endoscopy may provide therapy through a variety of mechanisms– via injection, mechanical, thermal, and topical therapies. If endoscopic treatment fails, angiography therapy or emergency surgery may be indicated[ 34 , 35 ]. The proposed algorithm for the management of early bleeding after bariatric surgery is described in Figure 2 .…”

Changes in clinical depression following Sleeve Gastrectomy

“…Based on clinical studies, bariatric surgery is the most effective treatment for obesity 13,22 . The number of SG complications is relatively low, and with a rate of about 1.6% to 2.3%, this type of operation can be considered safe 21,23 . SG procedure is the choice of more than 70% of patients in the United States, Europe and Israel who tend to undergo obesity surgery which has been trending among various types of bariatric surgery in the past 10 to 15 years 24 .…”

“… 13 , 22 The number of SG complications is relatively low, and with a rate of about 1.6% to 2.3%, this type of operation can be considered safe. 21 , 23 SG procedure is the choice of more than 70% of patients in the United States, Europe and Israel who tend to undergo obesity surgery which has been trending among various types of bariatric surgery in the past 10 to 15 years. 24 Although bariatric surgery is safe and has many health benefits, as mentioned, there are some complications reported in patients, which nutritional deficiencies leading to clinical depression are one of the major complications in post‐operative periods.…”

Role of Preoperative Esophagogastroduodenoscopy (EGD) in Bariatric Treatment

“…A review of multiple reports published over more than 10 years/with a greater than 10-year observation demonstrated that the percentage of excess weight loss (%EWL) could vary from 56.7% after gastric bypass (RYGB) to 45.9% after laparoscopic adjustable gastric banding (LAGB) and 58.3% after laparoscopic sleeve gastrectomy (SG) [16]. However, bariatric procedures also pose a considerable risk of complications [17][18][19], such as anastomotic leakage [20,21], bleeding [22,23], marginal ulcer [23,24], and anastomotic stenosis [24]. In the present study, 50% (n = 110) of the patients had a preoperative BMI ≥ 43.5 ± 4.3 m 2 , corresponding to severe obesity, in the case of which surgical treatment may produce desirable outcomes.…”