Early Postoperative Bleeding After Laparoscopic Roux-En-Y Gastric Bypass: a Single Center Analysis

Data de publicação: Data Ahead of Print:

Autores da FMUP

  • André Manuel Costa Pinho

    Autor

  • Hugo Miguel Teixeira Ferraz Santos Sousa

    Autor

Participantes de fora da FMUP

  • Pereira, A
  • Santos, RF
  • Silva, A
  • Nogueiro, J.
  • Carneiro, S
  • Lima-da-Costa, E
  • Preto, J.

Unidades de investigação

Abstract

Purpose Early postoperative bleeding is a common complication after laparoscopic Roux-en-Y gastric bypass (LRYGB) and is associated with significant morbidity. We aimed to identify predictors of early postoperative bleeding after LRYGB and characterize hemorrhagic events and 30-day postoperative outcomes. Material and Methods We conducted a retrospective cohort study regarding all patients submitted to LRYGB in 2019 at a high-volume obesity center. Early postoperative bleeding was defined as any clinically significant evidence of hemorrhage in the early postoperative period. Demographic, preoperative, and intraoperative factors were evaluated for associations with postoperative bleeding. Postoperative outcomes were compared between patients with and without hemorrhage. Results Of 340 patients submitted to LRYGB, 14 (4.1%) had early postoperative bleeding. Patients with bleeding had an increased preoperative left hepatic lobe diameter (8.4 vs. 7.3 cm, p = 0.048). Prior cholecystectomy (28.6 vs. 14.5%) and previous bariatric surgery (35.7 vs. 23.9%) tended to be more prevalent among these patients. Bleeding occurred at a median time of 31.2 [IQR 19.7-38.5] h. Thirteen patients presented with intraluminal bleeding and one with extraluminal bleeding. Melena was the most common symptom. All hemorrhages were clinically diagnosed, and 92.9% were managed conservatively. Postoperative bleeding was associated with longer hospital stay (3.5 vs. 2.0 days), higher reintervention (7.1 vs. 0%), and readmission (14.3 vs. 0%), all p < 0.05. Conclusions Bleeding was the most frequent early complication after LRYGB. Patients with hepatomegaly and prior surgeries may have technically challenging LRYGB and should be carefully assessed. Perioperative strategies should be encouraged in high-risk patients to prevent bleeding.

Dados da publicação

ISSN/ISSNe:
0960-8923, 1708-0428

Obesity Surgery  Springer New York

Tipo:
Article
Páginas:
1902-1908
Link para outro recurso:
www.scopus.com

Citações Recebidas na Web of Science: 7

Citações Recebidas na Scopus: 7

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Keywords

  • Obesity; Bariatric surgery; Laparoscopic Roux-en-Y Gastric Bypass; Risk factors; Postoperative complications; Bleeding

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Impact of serum albumin concentration and neutrophil-lymphocyte ratio score on gastric cancer prognosis

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Nutritional deficiencies in bariatric surgery patients: a comparison between Roux-en-Y Gastric Bypass and Sleeve Gastrectomy

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Resultados a curto prazo do Bypass Gástrico vs Sleeve Gástrico na Super Obesidade: análise num único centro

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Roux-en-Y Gastric Bypass and Sleeve Gastrectomy as Revisional Bariatric Procedures after Adjustable Gastric Banding: a retrospective cohort study

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Estudo Clínico Académico (Gastric Bypass) . 2021

Early postoperative bleeding after Laparoscopic Roux-En-Y Gastric Bypass: a single center analysis

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Estudo Clínico Académico . 2021

Health related Quality of Life six years after bariatric surgery: factors influencing outcome

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High-Sensitivity modified Glasgow Prognostic Score (HS-mGPS) as a predictor of overall survival in gastric cancer patients submitted to curative-intent surgery

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Estudo Clínico Académico . 2020

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