Postoperative bleeding after laparoscopic Roux en Y gastric bypass: predictors and consequences

Zafar, Syed Nabeel; Miller, Kaylie; Felton, Jessica; Wise, Eric S.; Kligman, Mark D.

doi:10.1007/s00464-018-6365-z

Cited by 29 publications

(26 citation statements)

References 23 publications

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“…According to previous reports, the probability of abdominal hemorrhage after bariatric surgery ranges from 1.5% to 2.0%[3]. In total, 343 metabolic procedures have been performed in our center this year, among which six cases of hemorrhage occurred (incidence of 1.7%).…”

Section: Discussionmentioning

confidence: 92%

Role of abdominal drainage in bariatric surgery: Report of six cases

Liu

Zhang

2019

WJCC

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BACKGROUND Abdominal drainage allows for timely detection of hemorrhage, but it cannot prevent hemorrhage. Whether routine abdominal drainage is needed during bariatric procedures remains controversial. Few reports describe the role of abdominal drainage in the diagnosis and treatment of abdominal hemorrhage in bariatric surgery. CASE SUMMARY Six cases of hemorrhage after bariatric surgery were described, including three cases with and three without abdominal drainage during the first surgery. The hemorrhage in five of the six cases was controlled by conservative treatment. Abdominal hemorrhage was found through the drainage tube on the day of the operation in the three patients with abdominal drainage during the first surgery. Emergency treatment was initiated, and their conditions gradually stabilized within 48 h. No patients required a reoperation. Abdominal hemorrhage was found later in the patients without abdominal drainage. Although the hemorrhage was controlled by conservative treatment in two cases (1 and 2), reoperation and percutaneous drainage were performed for abdominal infection and pelvic hemorrhage. An obsolete encapsulated effusion that may require treatment in the future was left in the abdominal cavity of a patient (Case 1). CONCLUSION The possibility of controlling abdominal hemorrhage after bariatric/metabolic surgery by conservative treatment is high. When hemorrhage occurs, abdominal drainage can reduce the probability of reoperation by reducing the formation of blood clots behind the stomach.

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Section: Discussionmentioning

confidence: 92%

Role of abdominal drainage in bariatric surgery: Report of six cases

Liu

Zhang

2019

WJCC

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“…Weight gain occurs in about 20 % of patients after laparoscopic RYGB [65,22,51]. In the study, weight gain of more than 10 % of the lowest body weight in the postoperative period was recorded in 24 % of patients [75]. In a 2007 study, from 782 patients, weight gain was noted in 46 % two years after surgery and in 64 % 4 years after surgery [49].…”

Section: Reviews оглядиmentioning

confidence: 91%

“…Some researchers consider weight gain as the difference between the highest and lowest body weight after surgery; increase in Body Mass Index; % EWL = lost body weight (kg) : overweight (kg) • 100, or the difference between the weight before and after the operation expressed as a percentage [5,75,47]. Weight gain occurs in about 20 % of patients after laparoscopic RYGB [65,22,51].…”

Section: Reviews оглядиmentioning

confidence: 99%

Early and late complications after gastric bypass: A literature review

Nevmerzhytskyi

2021

ЗХ

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Over the last few decades, excess weight and obesity have become a considerable health problem that has a lasting impact on communities worldwide. According to the WHO, about 1.9 billion people over the age of 18 are overweight [32]. Obesity accounted for about 4.7 million premature deaths in 2017. Globally, obesity was associated with an increase in mortality rate from 4.5 % in 1990 to 8 % in 2017 [32]. Bariatric surgery is currently recognized as the most effective treatment option for morbid obesity. Over the past 10 years, gastric bypass surgery has proved more effective than any other surgical methods due to its optimal metabolic effects. The aim of the review is to carry out an analysis of literature data in order to identify main complications after gastric bypass in patients with obesity. The complication rate after bariatric surgery decreased from 10.5 % in 1993 to 7.6 % in 2006 [3]. The mortality rate after bariatric surgery was 0.08 % within 30 days after surgery and 0.31 % after 30 days [13]. According to the BOLD study (2010), for 57,918 bariatric operations, the complication rate was 6,240 (10.77 %) and the mortality rate was 78 (0.135 %), within 30 days after surgery — 0.089 %, within 90 days after surgery — 0.112 %. Roux‑en‑Y Gastric Bypass (RYGB) was carried out in 30,864 cases, and 4,588 (14.87 %) patients developed postoperative complications. Early complications include anastomotic leaks (0 — 5,6 % for laparoscopic approach and 1,6 — 2,6 % — for laparotomy), small bowel obstruction caused by a blood clot (0 — 0,5 %), bleeding from the sutures (1,5 %), and thromboembolic complications (0,2 — 5 %). Late complications include stenosis of the gastrointestinal tract (3 — 27 %), marginal ulceration (MU) — 0,6 — 16 %, an incarcerated Petersen’s space hernia — 2,51 %, perforation of the stomach and small intestine (1 — 2 %), gastrogastric fistula formation — 1,5 — 6,0 %, weight regain (to 17,1 %). Increasing global demand for bariatric surgery as the best option for the management of excess weight and obesity necessitates more detailed investigation of possible complications it may induce. Therefore, further research is required to develop and study new effective methods for prevention and treatment of complications after surgical treatment of patients with morbid obesity.

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“…Bleeding after RYGB typically occurs acutely after surgery (< 48 h), while late bleeding (> 30 days) is usually caused by ulceration which will be covered in the next section. The incidence of bleeding after RYGB is between 1.5%-4.4% [58][59][60] . Bleeding may be intraluminal at an anastomosis or can be intraabdominal from a staple line, port site, or site of adhesiolysis.…”

Section: Bleedingmentioning

confidence: 99%

Revisional bariatric surgery: a review of workup and management of common complications after bariatric surgery

Lyons¹,

Omar²,

Tholey³

et al. 2022

MIS

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With the rising prevalence of obesity, there has been a steady rise in the number of bariatric surgeries performed worldwide. As expected, there has also been an increase in the number of revisional surgeries performed to manage acute and chronic postoperative complications. This review will discuss the major complications that can arise from the most common bariatric surgeries, their diagnosis, medical management, and potential revisional surgical options.

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Postoperative bleeding after laparoscopic Roux en Y gastric bypass: predictors and consequences

Abstract: Postoperative bleeding occurs in 1.5% of patients undergoing a LRYGB and is associated with significantly increased morbidity and mortality. We have identified patient and operative factors that are independently associated with postoperative bleeding.

Cited by 29 publications

References 23 publications

Role of abdominal drainage in bariatric surgery: Report of six cases

Role of abdominal drainage in bariatric surgery: Report of six cases

Early and late complications after gastric bypass: A literature review

Revisional bariatric surgery: a review of workup and management of common complications after bariatric surgery

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