Simplified Fast-Track Laparoscopic Roux-en-Y Gastric Bypass

Abstract

Our simplified fast-track LRYGB service allows the vast majority of patients to be safely and successfully discharged on postoperative day 1.

Outcome of Laparoscopic Gastric Bypass (LRYGB) with a Program for Enhanced Recovery After Surgery (ERAS)

“…A literature search revealed nine relevant articles reporting outcomes following LRYGB with ERAS programs [15][16][17][18][19][20][21][22][23]. These reports and our results are summarized in Table 4.…”

“…The same group described later a more detailed fast track protocol in a larger cohort in 2012 [20]. Only recently, a few reports on outcomes after bariatric surgery following specific ERAS programs have been published [15,18,19,21,23], usually with similar short LOS and low complication rates. The literature remain scarce, and all these aforementioned publications come from high-volume and specialized bariatric centers.…”

“…A discrepancy in what is reported and what is not can be seen in Table 4. The D-C classification [11] of postoperative morbidity has gained wide acceptance in all fields of surgery and is used also by some authors in their outcome reports concerning ERAS programs after LRYGB [19,21,23], but not by all [15-18, 20, 22]. Most studies report only 30 days' morbidity leaving more long-term morbidity unreported.…”

Fast-Track in Bariatric and Metabolic Surgery: Feasibility and Cost Analysis Through a Matched-Cohort Study in a Single Centre

“…Discharge at postoperative D1 should be allowed depending on white blood cells count <17,000 and serum CRP <100 [33,34] as well as physiological vital parameters, absence of nausea and vomiting, adequate food intake, and adequate pain control [15].…”

“…Patients were allowed to have a thick liquid diet and were discharged after a dietary consult; white blood cells count <17,000 mg/dl and CRP <100 [15], no fever (temperature < 38°), no tachycardia (rate < 100 per minute), normal blood pressure (<160/90 mmHg), adequate pain control, and adequate oral intake were the formal criteria for discharge.…”