Early Postoperative Bleeding After Laparoscopic Roux-En-Y Gastric Bypass: a Single Center Analysis
Autores da FMUP
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
- Tipo:
- Article
- Páginas:
- 1902-1908
- Link para outro recurso:
- www.scopus.com
Obesity Surgery Springer New York
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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Citar a publicação
Pereira A,Santos RF,Costa A,Silva A,Nogueiro J,Carneiro S,Lima E,Santos H,Preto J. Early Postoperative Bleeding After Laparoscopic Roux-En-Y Gastric Bypass: a Single Center Analysis. Obes. Surg. 2022. 32. (3):p. 1902-1908. IF:2,900. (2).