The enemy of good is better, colonic obstruction post gastric bypass: an international video case series

Karthikeyan, R; Takla, Hany; Delko, Tarik; Badaoui, Joseph N.; Kellog, Todd A.; Ghanem, Omar M.

doi:10.1016/j.soard.2021.01.038

Cited by 1 publication

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“…Third, the MBSAQIP does not mention the anatomic location of BO. The latter is most likely in the small bowel; nevertheless, colonic obstruction—although rarely—has also been reported after bariatric surgery 29 . Finally, the sample size that we had for the DS cohort was relatively small when compared with our RYGB and SG cohorts.…”

Section: Discussionmentioning

confidence: 88%

“…The latter is most likely in the small bowel; nevertheless, colonic obstruction-although rarely-has also been reported after bariatric surgery. 29 Finally, the sample size that we had for the DS cohort was relatively small when compared with our RYGB and SG cohorts. This could potentially explain the lack of significance for many of the risk factors of BO in that group.…”

Section: Discussionmentioning

confidence: 98%

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Early Bowel Obstruction after Bariatric Surgery: An Analysis of the 2020-2021 MBSAQIP Database

Clapp,

Abi Mosleh,

Corbett

et al. 2023

Surgical Laparoscopy, Endoscopy &Amp; Percutaneous Techniques

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Background: The Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program evaluates 30-day outcomes of bariatric cases performed in the United States. The Participant Use File in 2020 introduced bowel obstruction (BO). We compared the rates of BO, risk factors, and postoperative outcomes after laparoscopic Roux-en-Y gastric bypass (RYGB), sleeve gastrectomy (SG), and duodenal switch (DS). Methods: Retrospective analysis of patients who underwent laparoscopic RYGB, SG, or DS obtained from the 2020-2021 Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program. Patients who underwent either as a primary procedure with a body mass index >35 kg/m2 were selected. Baseline characteristics, operative details, and postoperative complications were collected. The outcome of interest was BO occurring within 30 days. Results: A total of 205,533 cases of which 148,944 were SG (72.4%), 54,606 were RYGB (26.5%), and 1983 were DS (1%). BO occurred in 0.74%, 0.4%, and 0.03% of patients who underwent an RYGB, DS, or SG, respectively. Patients with a BO in the RYGB group were more likely to be on immunosuppressive therapy (5.4% vs. 1.9%, P<0.001) with longer operative time (136.2 min±58.0 min vs. 117.4 min±53.6 min, P<0.001). SG patients with a BO were older (47.5±13.6 vs. 41.9±11.6, P=0.011) with longer operating times (98.6±63.8 vs. 68.9±33.4, P=0.002). Patients in the RYGB group with a BO had the highest rates of readmissions (71.9%) and reoperations (58.4%). Conclusions: Early bowel obstruction is rare after bariatric surgery. It is more common after RYGB and least common after SG. Readmission and reoperation rates were highest in patients with BO in the RYGB group.

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Section: Discussionmentioning

confidence: 88%

Section: Discussionmentioning

confidence: 98%