Operative and Postoperative Complications of Laparoscopic Sleeve Gastrectomy in Super and Nonsuper Obese Patients: A Center of Excellence Experience Comparative Study

Vilallonga, Ramón; Hidalgo, Marta; Gordejuela, Amador García Ruiz de; Caubet, Enric; González, O.; Ciudin, Andrea; Rodríguez-Luna, María Rita; Roriz-Silva, Renato; Petrola, Carlos; Armengol, Manel; Fort, José Manuel

doi:10.1089/lap.2019.0721

Cited by 11 publications

(5 citation statements)

References 20 publications

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“…Compared with Roux-en-Y gastric bypass surgery, LSG has shown lower morbidity [ 11 ]. The morbidity rate associated with LSG ranges from 0–16.7% [ 4 , 12 ]. In a meta-analysis of 1,112 cases post-LSG, 1.35% included gastric bleeding, 0.84% included abdominal abscess, 0.17% included internal abdominal hernia, 0.17% included gastric leakage, 4.9% included reflux, and 0.34% included gastric ulcers [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

Mesenteric Vein Thrombosis following Sleeve Gastrectomy: A Case Report and Review of the Literature

Ma,

Zhao,

Zhang

et al. 2024

Obes Facts

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Introduction: Acute mesenteric ischemia (AMI) is a rare but lethal disease. Mesenteric venous thrombosis (VAMI) is a subtype of AMI. Morbid obesity is usually accompanied by hypertension, hyperlipidemia or diabetes mellitus, which are risk factors associated with AMI. Case presentation: We present a 28-year-old man with mesenteric venous thrombosis post laparoscopic sleeve gastrectomy (LSG). He was first misdiagnosed with intestinal obstruction. Superior mesenteric vein thrombosis was confirmed after computed tomography angiography (CTA). Laparotomy, resection of necrotic small bowel and ostomy were performed immediately. Conclusion: Patients with morbidly obese accompanied by hypertension, hyperlipidemia or diabetes mellitus have a high risk of AMI. Abdominal pain with sudden onset should be considered as AMI. Anticoagulation therapy post sleeve gastrectomy might help to reduce the incidence of AMI.

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Section: Discussionmentioning

confidence: 99%

Mesenteric Vein Thrombosis following Sleeve Gastrectomy: A Case Report and Review of the Literature

Ma,

Zhao,

Zhang

et al. 2024

Obes Facts

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“…Leak at the angle of His is the most concerning adverse event due to the linked morbidity and mortality. Various pathophysiological explanations for the leak have been described in the literature, one of which is variation in pressure due to uneven staple line, tight incisura, or twist [4][5][6]. The treatment for post-SG leakage may include surgical or endoscopic drainage; endoscopic management including clipping and stenting; and rarely surgical intervention and revisional bariatric surgery [7].…”

Section: Discussionmentioning

confidence: 99%

A Case of a Gastric Stent Complication Presenting With a Gastrojujenal Fistula

Breakeit,

Gheshayan,

Alamri

et al. 2023

Cureus

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Laparoscopic sleeve gastrectomy (SG) is a widely performed bariatric procedure known for its safety and efficacy, yet complications, particularly postoperative leaks, remain a concern. Endoscopic stenting is one of the approaches for leak management that has some complications such as the rare fistula with adjacent organs. Here, we present a unique case of a 56-year-old diabetic female who developed a gastroenteric fistula following endoscopic stent placement for a post-SG leak. The patient had a delayed stent removal, and three weeks later she presented with dysphagia and vomiting in a follow-up appointment. Esophagogastroduodenoscopy (EGD) showed an esophageal stricture and a large gastroenteric fistula that was confirmed by imaging to be a fistula between the pylorus and proximal small bowel. The patient's symptoms improved gradually with conservative management, and imaging showed the resolution of the fistula and associated esophageal stricture. This case highlights the importance of timely stent removal (ideally within 6-8 weeks) and close follow-up with EGD and CT to detect and manage potential complications, while emphasizing the need for further research on optimal stent placement duration.

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“…According to the literature, 3.1-8.8% of patients have early postoperative complications [14][15][16][17] and 0.9-9.4% of patients return to the operating room [18,19]. Postoperative hemorrhage is one of the most common early complications occurring both intraluminal and intraabdominal (i.e., from the staple line, omentum, port sites, or damage to the liver or spleen).…”

Section: Discussionmentioning

confidence: 99%

“…Literature reports a wide range of post-bariatric surgery complications, from 1 to 29%. Most common postoperative complications reported include leakage, hemorrhage, fistula, surgical site infection, abscess, gastric dilatation, stricture, wound complication, and nutritional deficiencies [3][4][5]. Hemorrhage represents a life-threatening complication, occurring in 1.3-1.7% of bariatric surgeries.…”

Section: Introductionmentioning

confidence: 99%

Bariatric surgery: to bleed or not to bleed? This is the question

et al. 2022

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Background Bariatric surgery procedures are the most successful and durable treatment for morbid obesity. Hemorrhage represents a life-threatening complication, occurring in 1.3–1.7% of bariatric surgeries. Materials and methods We examined patients undergoing Bariatric Surgery from July 2017 to June 2020 (Group A) and those operated from July 2020 to June 2022 (Group B) in our Department. Starting from July 2020 we have implemented intraoperative measures to prevent postoperative bleeding, increasing mean arterial pressure (MAP) by 30% compared to preoperative and reducing the pneumoperitoneal pressure of CO2 to 8 mmHg in the last 15 min of the operation. Results The study gathered 200 patients divided into the two described groups. The mean age of Group A is 44 ± 8.49 and 43.73 ± 9.28. The mean preoperative BMI is 45.6 kg/m2 ± 6.71 for Group A and 48.9 ± 7.15 kg/m2 for Group B. Group A recorded a mean MAP of 83.06 ± 18.58 mmHg and group B a value of 111.88 ± 12.46 mmHg (p value < 0.05 and z-score is 4.15226 and the value of U is 13,900). We observed 9 cases of bleeding in group A, most of them being treated with medical therapy and transfusions; only 1 hemodynamically unstable patient underwent re-laparoscopy. We reported only 2 cases of bleeding in group B, one of which required blood transfusions. Conclusion From our study we can conclude that increasing mean arterial pressure (MAP) by 30% compared to preoperative and reducing the pneumoperitoneum pressure of CO2 to 8 mmHg in the last 15 min of the operation led to a decrease in bleeding cases in group B and, most importantly, all the bleedings were easily controllable with medical therapy and/or transfusions. These measures allowed us to reduce postoperative bleeding.

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Operative and Postoperative Complications of Laparoscopic Sleeve Gastrectomy in Super and Nonsuper Obese Patients: A Center of Excellence Experience Comparative Study

Cited by 11 publications

References 20 publications

Mesenteric Vein Thrombosis following Sleeve Gastrectomy: A Case Report and Review of the Literature

Mesenteric Vein Thrombosis following Sleeve Gastrectomy: A Case Report and Review of the Literature

A Case of a Gastric Stent Complication Presenting With a Gastrojujenal Fistula

Bariatric surgery: to bleed or not to bleed? This is the question

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