Complications After Laparoscopic Gastric Bypass

Inferior vena cava filters and postoperative outcomes in patients undergoing bariatric surgery: a meta-analysis

“…Postoperative PE is diagnosed in only 0.41-1.2% of laparoscopic and open RYGB patients, even though up to 80% of patients who died from other causes after bariatric surgery were found to have silent PEs found at autopsy [13,14] .…”

“…Unfortunately, causes of death were not consistently reported in included studies; only Overby et al [12] reported one out of three deaths related to PE. It has been reported that some unexplained deaths after bariatric surgery may be related to undiagnosed PE [1,12,14,16] , so this can be a cause of death that should be explored.…”

Stenosis in laparoscopic gastric bypass: management by endoscopic dilation without fluoroscopic guidance

“…Published studies are not clear when it comes to describing this aspect. The minority of them clearly manifest not using fluoroscopy during dilation (4,18), others claim to have used it in all or in one of their patients (5,6,8,11,16), and finally, others do not make any sort of comment in this regard in their publications (9,10,14,15,17). Our experience demonstrates that carrying out dilations in patients with stenosis of the anastomosis in the gastric bypass is possible without a fluoroscopic guidance, allowing carrying out the technique in the simplest manner, in the same endoscopy room, without radiation for the patient or for the medical staff, and probably for a shorter period of time.…”

“…This route offers clear advantages compared to open surgery, such as: less blood loss during surgery, less postoperative pain, a lower incidence of wound infections, a shorter hospital stay, and a shorter period of recovery (2). The stenosis of the stoma (stenosis of the gastro-jejunal anastomosis) occurs in approximately 3-12% after gastric bypass, and must be suspected when the patient experiences dysphagia, nausea and vomiting (2)(3)(4)(5)(6)(7)(8)(9). Endoscopic dilation of the stenosis by means of a balloon or bougie is considered the treatment of choice, even if in most studies it is not quite clear whether it should be done with or without a radioscopic guidance (4)(5)(6)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) In this study, we informed of our experience in the management of the stenosis of the stoma in patients with laparoscopic gastric bypass by means of endoscopic dilation with a hydrostatic balloon, without fluoroscopic guidance.…”

Best Practice Recommendations for Surgical Care in Weight Loss Surgery

“…Data associate it with a decrease in the frequency of iatrogenic splenectomy, wound infection, incisional hernia, and mortality and with increases in the frequency of early and late bowel obstruction, gastrointestinal tract hemorrhage, and stomal stenosis (42). The procedure is known to have a longer and more complex learning curve than other advanced laparoscopic techniques (3,43,44).…”