Leakage and internal herniation are the most common complications after gastric bypass

Dan Med J. 2014 May;61(5):A4844.

Abstract

Introduction: The aim is to report the diagnostic strategy, clinical findings and treatment in patients admitted on suspicion of early or late complications associated with a previous laparoscopic Roux-en-Y gastric bypass (LRYGB).

Material and methods: Patients admitted in 2011-2012 to our department with the International Classification of Diseases 10 code DZ980C (condition with a gastric bypass) were identified using the Hospital register system. Patient data included co-morbidity, time between LRYGB and the actual admission, body mass index development, diagnostic strategy, clinical findings and treatment of complications. Early and late complications were defined as </> 30 days post-operatively.

Results: Among 186 patients, the primary early complication was leakage or unexplained abdominal pain. Internal hernia or unexplained abdominal pain was observed most frequently as a late complication. The majority of patients had a computed tomography performed as their first diagnostic procedure. 19% of patients who were operated for internal hernia underwent a re-operation. Among patients undergoing laparoscopy, 72% had internal hernia and 20% had a leak. The length of stay was 18 days for patients with leakage compared to three days for patients with internal hernia.

Conclusion: In conclusion, the primary early complication of LRYGB patients was leakage, and internal hernia was the most frequent late complication. A substantial number of the patients who are readmitted after LRYGB suffer from unexplained abdominal pain that should be managed by specialised centres.

Funding: not relevant.

Trial registration: not relevant.

MeSH terms

  • Abdominal Pain / etiology
  • Abdominal Pain / surgery
  • Adult
  • Anastomosis, Roux-en-Y / adverse effects
  • Anastomotic Leak / diagnosis
  • Anastomotic Leak / etiology*
  • Anastomotic Leak / surgery
  • Constriction, Pathologic / etiology
  • Constriction, Pathologic / therapy
  • Female
  • Gastric Bypass / adverse effects*
  • Hernia / diagnosis
  • Hernia / etiology*
  • Hernia / therapy
  • Herniorrhaphy
  • Humans
  • Jejunum / pathology
  • Jejunum / surgery*
  • Laparoscopes / adverse effects*
  • Length of Stay
  • Male
  • Middle Aged
  • Reoperation
  • Stomach / pathology
  • Stomach / surgery*
  • Time Factors
  • Tomography, X-Ray Computed
  • Young Adult