Incidence and risk factors for early gastrojejunostomy anastomotic stricture requiring endoscopic intervention following laparoscopic Roux-en-Y gastric bypass: a MBSAQIP analysis

Khrucharoen, Usah; Weitzner, Zachary; Chen, Yijun; Dutson, Erik

doi:10.1007/s00464-021-08700-x

Cited by 6 publications

(3 citation statements)

References 35 publications

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“…Such rates include both early and late postoperative periods. Most strictures typically occur early following RYGB, with incidence rates of 0.8-5% [51][52][53][54]. These strictures most commonly occur at two sites: the jejunojejunostomy and the gastrojejunostomy, with the latter being the primary location of occurrence.…”

Section: Anastomotic Stricturementioning

confidence: 99%

The Trajectory of Revisional Bariatric Surgery: Open to Laparoscopic to Robotic

Jawhar,

Sample,

Salame

et al. 2024

JCM

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Metabolic and bariatric surgery (MBS) is the most effective therapeutic intervention for patients with obesity, with sleeve gastrectomy (SG) being the most commonly performed primary MBS procedure. Long-term studies have demonstrated that 15–20% of patients require revisional bariatric surgery (RBS) due to weight-related issues or surgical complications. Despite the gold standard being laparoscopic revision, there are other available approaches such as open or robotic-assisted. An extensive literature review was performed for articles from their inception to February 2024. A descriptive review of MBS procedures (SG, Roux-en-Y gastric bypass (RYGB), single anastomosis duodeno-ileostomy (SADI) and biliopancreatic diversion-duodenal switch (BPD-DS)) was carried out to report and compare outcomes between primary and revisional bariatric surgery. A similar review was conducted to compare outcomes of revisional approaches (open, laparoscopic, robotic). RYGB remains the dominant RBS with a similar safety profile compared to revisional SADI and BPD-DS. In terms of the RBS surgical approach, all three options showed comparable short and long-term outcomes, with robotic RBS being associated with longer operative time and variable length of stay. Additional long-term studies are required to further validate our conclusions.

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Section: Anastomotic Stricturementioning

confidence: 99%

The Trajectory of Revisional Bariatric Surgery: Open to Laparoscopic to Robotic

Jawhar,

Sample,

Salame

et al. 2024

JCM

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“…Following SBO, another late complication of gastric bypass is stricture, which typically take at least 4 to 6 weeks to develop and occurs most commonly at the gastrojejunal anastomosis. 59,60 Progressive intolerance to solids more than liquids and pain with eating are usual presenting signs. Upper endoscopy should be performed, and most strictures respond to serial balloon or bougie dilation.…”

Section: Late Complications (>30 Postoperative Days): Internal Hernia...mentioning

confidence: 99%

Common postbariatric surgery emergencies for the acute care surgeon: What you need to know

Cheng,

Samakar,

Dobrowolsky

et al. 2023

J Trauma Acute Care Surg

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The field of bariatric and metabolic surgery has changed rapidly over the past two decades, with an exponential increase in case volumes being performed because of its proven efficacy for morbid obesity and obesity-related comorbidities. Although this increased volume of procedures has been accompanied by significant decrease in postoperative complication rates, there are numerous potential complications after bariatric surgery that may require urgent or emergent surgical evaluation or interventions. Many of these risks extend well beyond the early postoperative period and can present months to years after the index procedure. Acute care surgeons are increasingly covering most or all of the emergency general surgery services at many centers and must be familiar with the numerous bariatric surgical procedures being performed and their individual complication profile to provide optimal care for these frequently challenging patients. This article provides a focused and concise review of the common bariatric procedures being performed, their early and late complication profiles, and a practical guide to the optimal diagnostic evaluations, surgical interventions, and perioperative management options. The author group includes both acute care surgeons and bariatric surgeons with significant experience in the emergency management of the complicated postbariatric surgical patient. LEVEL OF EVIDENCE Literature Synthesis and Expert Opinion; Level V.

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“…In einer aktuellen Analyse der MBSAQIP-Datenbank zeigte sich eine Inzidenz von 4,7 Stenosen per 1000 Personenjahren nach RYGB bei den Patienten, die in den ersten 30 Tagen postoperativ eine ÖGD bekommen haben, 85 % der Patienten benötigten eine therapeutische Intervention [40]. Die Anastomosenstenose nach Schlauchmagen-OP oder nach RYGB ist meistens eine späte Komplikation [41,42].…”

Section: Stenoseunclassified

Endoskopisches Komplikationsmanagment nach bariatrischen Operationen mit dem Fokus auf die aktuellen endoskopischen Therapien

2022

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ZusammenfassungKomplikationen nach bariatrischer Chirurgie sind selten. Die meisten Komplikationen lassen sich endoskopisch oder mithilfe der Endoskopie therapieren. Das Seltene stellt jedoch im klinischen Alltag eine Herausforderung dar. Damit die Komplikationen bestmöglich versorgt werden und der Schaden für den einzelnen Patienten möglichst gering ist, bedarf es eines Komplikationsmanagements. Der Artikel gibt eine Übersicht über wesentliche Komplikationen und gängige endoskopische Therapieoptionen, mit dem Fokus auf aktuelle publizierte Therapiestrategien der letzten 5 Jahre. Der Artikel soll als Basis dienen für die Etablierung eines eigenen Komplikationsmanagements in den jeweiligen Kliniken.

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Incidence and risk factors for early gastrojejunostomy anastomotic stricture requiring endoscopic intervention following laparoscopic Roux-en-Y gastric bypass: a MBSAQIP analysis

Cited by 6 publications

References 35 publications

The Trajectory of Revisional Bariatric Surgery: Open to Laparoscopic to Robotic

The Trajectory of Revisional Bariatric Surgery: Open to Laparoscopic to Robotic

Common postbariatric surgery emergencies for the acute care surgeon: What you need to know

Endoskopisches Komplikationsmanagment nach bariatrischen Operationen mit dem Fokus auf die aktuellen endoskopischen Therapien

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