Early surgical complications after gastric by-pass: a literature review

Acquafresca, Pablo; Palermo, Mariano; Rogula, Tomasz; Duza, Guillermo; Serra, Edgardo

doi:10.1590/s0102-67202015000100019

Cited by 72 publications

(62 citation statements)

References 34 publications

(56 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Much less frequently, the bleedings are caused by iatrogenic injuries of the liver and spleen or trocar wounds. The majority of late postoperative bleedings are intraluminal [5,7]. They may develop several months and even years after surgery, being most commonly caused by ulcers in gastrojejunoanastomosis or the remnant stomach and duodenum [1,4,6,7].…”

Section: Discussionmentioning

confidence: 99%

“…The bleeding which starts 6 hours postoperatively and is accompanied by hematocrit rate reduction is usually the evidence of continuous bleeding, in most cases requiring urgent surgical intervention. On the contrary, if gastrointestinal bleeding occurs 48 hours after surgery and hematocrit rate is not significantly changed there is no need for active surgical manipulations [3,5].…”

Section: Discussionmentioning

confidence: 99%

“…Publications show a little higher risk of postoperative bleeding in laparoscopic aproach (1.9%) as compared to open surgery (0.6%) [3][4][5][6]. Bleedings after surgery can be specified as early ones developing before the 30 th postoperative day and late ones-after the 30 th postoperative day [1,2,7].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Bleeding after Gastric Bypass Surgery: The Possibility of using of Postoperative Balloon Enteroscopy

Mo¹,

As²,

Dv³

et al. 2017

J Gastrointest Dig Syst

View full text Add to dashboard Cite

In the majority of cases late postoperative bleedings are intraluminal ones, showing clinical manifestations of high gastrointestinal hemorrhage. Among all bariatric procedures, this complication develops more commonly after Rouxen-Y gastric bypass. The most likely cause of such bleedings being peptic ulcer, conservative therapy with proton pump inhibitors is well justified at the initial stages of treatment. Upper endoscopy is the treatment of choice for bleeding ulcers localized in the pouch and 80% of bleedings in the pouch or gastroenteroanastomosis can be controlled in this way.If the bleeding is localized in the remnant stomach or duodenum and small intestine, more advanced endoscopic procedures are needed. Balloon enteroscopy is one of such techniques, although its efficacy in the treatment of bleeding resulting from biliopancreatic limb is extremely variable and depends mainly on specialist's skills, length of intestinal loop as well as severity of adhesions in the abdominal cavity. The article describes our experience of enteroscopy used to control bleeding from duodenal ulcer after Roux-en-Y gastric bypass intervention.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Bleeding after Gastric Bypass Surgery: The Possibility of using of Postoperative Balloon Enteroscopy

Mo¹,

As²,

Dv³

et al. 2017

J Gastrointest Dig Syst

View full text Add to dashboard Cite

show abstract

“…Abdominal insufflation is performed at 14 mmHg was obtained with a Veress needle placed through the umbilicus of the patient (27,(33)(34)(35)(36)(37). Trocar placement: 10 mm in the midline (between xyphoid and umbilicus); two of 12 mm, one in the right upper quadrant and a left one in the mid-clavicular line; after that two more 5-mm trocars were used, one for liver retraction just distal to the xyphoid; and the other 5-mm of distal to the costal margin ( Figure 1A,B).…”

Section: Rygb Technique Descriptionmentioning

confidence: 99%

“…Several trials demonstrated that the duodenum and jejunum sense nutrients and initiate a feedback response through the gut-brain-liver axis to regulate hepatic glucose production. When nutrients are delivered to medium jejunum led a greater insulin sensitivity for glucose and fatty acids (20,26,(31)(32)(33)(34)(35)(36)(37)(38)(39). …”

mentioning

confidence: 99%

Metabolic surgery: gastric bypass for the treatment of type 2 diabetes mellitus

Quevedo

Palermo

Serra

et al. 2017

Transl. Gastroenterol. Hepatol.

Self Cite

View full text Add to dashboard Cite

Type 2 diabetes mellitus (T2DM) is one of the largest health emergencies of the 21st century given the worldwide increase of obesity during the last decades and its close association. T2DM is an inherited, polygenic and chronic disease caused by the interaction between several genetic variants in genes and the environment. The continuous search for new and more effective tools to achieve appropriate glycemic control became imperative in order to reduce long-term complications and mortality rates related to T2DM. Treatment options includes lifestyle modifications and several pharmacotherapies as first step in the therapeutical algorithm, but high corps of evidence have shown that gastrointestinal (GI) operations, especially those that involve food rerouting through the GI tract, are safe interventions and achieve superior outcomes for improvement in glucose metabolism when comparing with optimal medical and lifestyle changes. GI Surgery, specially Roux-en-Y gastric bypass (RYGB), is currently the most accepted surgical procedure to treat T2DM, and has also demonstrated to reduce significantly other cardiovascular risk factors (lipids and blood pressure control) when compared with optimal medical treatment, with good long-term effects on cardiovascular risks and mortality. Although the most effective technique in achieving diabetes remission is biliopancreatic diversion, the effectiveness-adverse effects balance is superior for RYGB. For these reasons, metabolic surgery (which was defined as "the operative manipulation of a normal organ or organ system to achieve a biological result for a potential health gain") has been considered and accepted as a new step in the therapeutic algorithm for T2DM when optimal lifestyle and medical interventions don't achieve optimal glycemic goals. for T2DM are glycated hemoglobin (A1c) <7%, low-density lipoprotein cholesterol levels <100 mg/dL and blood pressure <130-80 mmHg (3,6), and less than 20% of USA patients achieve these levels in triple target despite having the best medical treatment. Bariatric surgery was first described just for reducing weight in severely obese patients. A Swedish Obese Subjects (SOS) study, demonstrated that the surgery group arm not only had more drastic and sustainable average reduction of excess body weight but also had remarkable beneficial effects on cardiovascular risk factors, such as waist circumference, blood pressure, glucose and insulin levels, uric acid, triglyceride and HDL cholesterol levels when compared with conventionally treated patients (7-10). Even though the SOS study showed a reduction of the number of cardiovascular events and overall mortality in the surgery group (HR 0.76, CI 95%) (11,12), one of the most relevant points was the finding of absence of significant relationship between cardiovascular mortality and body mass index (BMI) (7,13).Gastrointestinal (GI) operations have demonstrated, especially those that involve food rerouting through the GI tract that are safe and provide better outcomes for weight loss and...

show abstract