Diagnosis and Management of Partial Small Bowel Obstruction after Laparoscopic Antecolic Antegastric Roux-en-Y Gastric Bypass for Morbid Obesity

Cho, Minyoung; Carrodeguas, Lester; Pinto, David; Lascano, Charles A.; Soto, Flavia; Whipple, Oliver; Gordon, Richard E.; Simpfendorfer, Conrad; Gonzalvo, John Paul; Szomstein, Samuel; Rosenthal, Raúl J.

doi:10.1016/j.jamcollsurg.2005.10.018

Cited by 62 publications

(37 citation statements)

References 16 publications

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“…Gastrointestinal obstruction is a relatively uncommon complication after RYGB, with a reported incidence of 1.5-5.0% [32][33][34][35][36][37]. There are many potential causes of obstruction, including anastomotic edema or kinking, peritoneal adhesive bands, internal hernia, jejunal intussusception, and bezoar formation in the gastric pouch [38,39].…”

Section: Gastrointestinal Obstructionmentioning

confidence: 99%

Complications of Roux-en-Y gastric bypass and sleeve gastrectomy

Herron

Roohipour²

2012

Abdom Radiol

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Roux-en-Y gastric bypass and sleeve gastrectomy are two of the most common bariatric procedures performed in 2011. Although the complication rates associated with these procedures are low, the consequences of these complications are significant and can be associated with high morbidity and mortality. Timely diagnosis and proper management of these complications are extremely important. The most commonly used radiologic studies in bariatric surgery are the upper GI contrast study and the CT scan, which are used to rule out leak, obstruction, perforation, anastomotic stricture, or pouch dilatation. As with all imaging studies, a negative result should not override strong clinical suspicion of a complication.

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Section: Gastrointestinal Obstructionmentioning

confidence: 99%

Complications of Roux-en-Y gastric bypass and sleeve gastrectomy

Herron

Roohipour²

2012

Abdom Radiol

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“…Persisting pouch distension on follow-up and air/contrast material levels in the pouch and oesophagus are suggestive of a stricture (Figure 4b). Stricture at the jejunojejunal anastomosis is rare, with an incidence of 0.8% [17]. On fluoroscopy, contrast material is seen in a distended alimentary limb ( Figure 5).…”

Section: Complicationsmentioning

confidence: 99%

Imaging in bariatric surgery: service set-up, post-operative anatomy and complications

Shah¹,

Shah²,

Ahmed³

et al. 2011

BJR

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ABSTRACT. Obesity is an increasingly prevalent and costly problem faced by the healthcare system. The role of bariatric surgery in managing obesity has also increased with evidence showing a reduction in long-term morbidity and mortality. There are unique challenges faced by the radiology department in providing an imaging service for this population of patients, from technical and staffing requirements through to the interpretation of challenging post-surgical images. We describe these challenges and provide an overview of the most frequently performed procedures, normal postoperative imaging findings and the appearance of common complications. ObesityObesity is a multifactorial disease, which is increasing in incidence and prevalence. In 2006, 67% of men and 56% of women were classified as being either overweight or obese in England [1]. Overall, 24% of adults were classified as obese, an increase from 15% in 1993, and 16% of children aged 2-15 years were classified as obese, an increase from 11% in 1995. Estimates suggest that at the current rate of increase, by 2010 there will be 12 million adults and 1 million children categorised as obese. The body mass index (BMI, kg m -2 ) is the most widely used measure of obesity; BMI between 25 and 30 signifies being overweight and BMI greater than 30 signifies obesity. BMI greater than 35 with obesityrelated serious comorbidities or greater than 40 with or without comorbidities is defined as morbid obesity.

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“…Nintyfour percent of these patients were successfully managed laparoscopically. Laparoscopic management of these patients included adhesiolysis, closure of internal hernia defects, and reconstruction of the jejunojejunostomy [28]. Champion and Williams reported a 1.8% incidence of postoperative small bowel obstruction requiring surgical intervention, and noted that the incidence of small bowel obstruction was lower in patients with an antecolic Roux limb (0.43%) compared to patients with a retrocolic Roux limb (4.5) [29].…”

Section: Resultsmentioning

confidence: 99%

Laparoscopic gastric bypass for morbid obesity

2006

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Laparoskopischer Magenbypass bei morbider AdipositasZusammenfassung. Grundlagen: Die morbide Adipositas trifft in den Vereinigten Staaten bei mehr als 60 % der Erwachsenen mit Übergewicht zu und hat somit ein epidemisches Ausmaß eingenommen. Die konservativmedizinischen Therapieoptionen wie kalorienarme Diät, Bewegungsübungen, Verhaltensanpassung und medikamentöse Therapie versagen jedoch sehr oft. Die verschiedenen chirurgischen Therapieoptionen scheinen einen längerfristig anhaltenden Gewichtsverlust erzielen zu kön-nen. Dies hat in den letzten Jahren zu einem dramatischen Anstieg der Patienten geführt, die sich einer bariatrischen Operation unterzogen haben.Methodik: Mit Hilfe der Medline-Suche wurde eine Durchsicht der englischsprachigen Literatur über den laparoskopischen Bypass bei morbidem Adipositas durchgeführt.Ergebnisse: Die minimal-invasiven Eingriffe haben aufgrund des geringeren postoperativen Schmerzes, der geringeren Wund-und kardiopulmonalen Komplikationen und des schnelleren Erreichens der normalen körperli-chen Aktivität zu einer signifikanten Reduktion der perioperativen Morbidität geführt. Die Zahl der Dünndarmob-struktionen beim laparoskopischen Y-Roux Magenbypass scheint höher als bei offener Technik zu sein. Der über-wiegend große Teil dieser Komplikationen kann aber wiederum laparoskopisch therapiert werden. Ebenfalls ist die Zahl der Anastomosenstrikturen bei laparoskopisch operierten Patienten höher. Diese Patienten können jedoch endoskopisch behandelt werden und brauchen keine weitere chirurgische Intervention.Schlussfolgerungen: In USA hat sich der laparoskopische Y-Roux Magenbypass in kurzer Zeit zum Goldstandard der chirurgischen Therapie beim morbiden Adipositas entwickelt. Es konnte dabei auch gezeigt werden, dass der laparoskopische Y-Roux Magenbypass gleich effektiv ist wie der offene Eingriff.Schlüsselwörter: Adipositas, laparoskopischer Magenbypass. Summary. Background: Morbid obesity in the UnitedStates has reached epic proportions, with more than 60% of the adult population currently either overweight or obese. Since medical treatment options such as low-calorie diets, exercise programs, behavior modification, and pharmacotherapy often fail, numerous surgical options have been developed which have proved to be effective in achieving long-term maintenance of weight loss. This has resulted in a dramatic increase in the number of patients undergoing bariatric surgery in recent years.Methods: A review of the English language literature from Medline on laparoscopic gastric bypass for morbid obesity was undertaken.Results: The minimally invasive approach yields significantly decreased perioperative morbidity, principally due to lower postoperative pain, lower rates of woundrelated and cardiopulmonary complications, and quicker return to normal activities. Although the rate of small bowel obstruction appears to be higher following Laparoscopic Roux-en-Y gastric bypass (LRYGBP) than following open surgery, the vast majority of these patients can be managed laparoscopically. Addition...

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Diagnosis and Management of Partial Small Bowel Obstruction after Laparoscopic Antecolic Antegastric Roux-en-Y Gastric Bypass for Morbid Obesity

Cited by 62 publications

References 16 publications

Complications of Roux-en-Y gastric bypass and sleeve gastrectomy

Complications of Roux-en-Y gastric bypass and sleeve gastrectomy

Imaging in bariatric surgery: service set-up, post-operative anatomy and complications

Laparoscopic gastric bypass for morbid obesity

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