Predictors and outcomes of bleed after sleeve gastrectomy: an analysis of the MBSAQIP data registry

Mocanu, Valentin; Dang, Jerry; Ladak, Farah; Switzer, Noah; Birch, Daniel W.; Karmali, Shahzeer

doi:10.1016/j.soard.2019.07.017

Cited by 47 publications

(23 citation statements)

References 18 publications

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“…In our analysis, laparoscopic sleeve gastrectomy after gastric banding showed a leakage rate of 1.02%, which was higher than reported from primary LSG in the MBASQIP databaseranging from 0.6 to 0.9%. [15,25] In our study, patients converted to LRYGB had an anastomotic leakage percentage of 1.76%. It corresponded to the analysis from 2015 and was higher than the reported rate for primary LRYGB in MBSAQIP analysis (0.6%).…”

Section: Discussionmentioning

confidence: 57%

Safety of Single Stage Revision Laparoscopic Sleeve Gastrectomy Compared to Laparoscopic Roux-Y Gastric Bypass after Failed Gastric Banding

Janik

Ibikunle

Khan³

et al. 2020

OBES SURG

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Background Reoperation, after failed gastric banding, is a controversial topic. A common approach is band removal with conversion to laparoscopic Roux-Y gastric bypass (LRYGB) or laparoscopic sleeve gastrectomy (LSG) in a single-step procedure. Objective This study aimed to assess the safety of revisional surgery to LSG compared to LRYGB after failed laparoscopic adjustable gastric banding (LAGB) based on MBSAQIP Participant User File from 2015 to 2018. Methods Patients who underwent a one-stage conversion of LAGB to LSG (Conv-LSG) or LRYGB (Conv-LRYGB) were identified in the MBSAQIP PUF from 2015 to 2017. Conv-LRYGB cases were matched (1:1) with Conv-LSG patients using propensity scoring to control for potential confounding. The primary outcome was all-cause mortality. Results A total of 9974 patients (4987 matched pairs) were included in the study. Conv-LRYGB, as compared with conv-SG, was associated with a similar risk of mortality (0.02% vs. 0.06%; relative risk [RR], 0.33; 95% confidence interval [CI], 0.03 to 3.20, p = 0.32). Conversion to LRYGB increased the risk for readmission (6.16% vs. 3.77%; RR, 1.63; 95%CI, 1.37 to 1.94, p < 0.01); reoperation (2.15% vs. 1.36%; RR, 1.57; 95%CI, 1.17 to 2.12, p = <0.01); leak (1.76% vs. 1.02%; RR, 1.57; 95%CI, 1.72 to 2.42, p < 0.01); and bleeding (1.66% vs. 1.00%; RR, 1.66; 95%CI, 1.7 to 2.34, p < 0.01). Conclusions The study shows that single-stage LRYGB and LSG as revisional surgery after gastric banding, are safe in the 30-day observation with an acceptable complication rate and low mortality. However, conversion to LRYGB increased the risk of perioperative complications.

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Section: Discussionmentioning

confidence: 57%

Safety of Single Stage Revision Laparoscopic Sleeve Gastrectomy Compared to Laparoscopic Roux-Y Gastric Bypass after Failed Gastric Banding

Janik

Ibikunle

Khan³

et al. 2020

OBES SURG

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“…OSA has been identified as an independent risk factor for postoperative bleeding in patients undergoing LSG with an odds ratio of 1.22. 85 Ahmed et al 86 reported an odds ratio of 14.29 for hospital readmission and emergency department visits after bariatric surgery in patients with OSA compared with controls. Providers should balance the benefit and risks of delaying bariatric surgery for OSA workup and treatment with attention to risk stratification according to severity of disease.…”

Section: Postoperative Complications and Preventionmentioning

confidence: 99%

Bariatric surgery in patients with obstructive sleep apnea

Chen

Moon

Schumann

2022

International Anesthesiology Clinics

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According to the most recent International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) Worldwide Survey, there were 685,874 bariatric operations performed in 2016. 1 As the prevalence of obesity increases, the number of patients who undergo bariatric surgery will also continue to rise. Surgeons, anesthesiologists, and other perioperative providers need to be aware of important comorbidities associated with obesity, particularly obstructive sleep apnea (OSA), in order to decrease morbidity and mortality in patients undergoing bariatric surgery.Based on recent studies, the prevalence of OSA worldwide is nearing one billion persons. 2 The prevalence of OSA in the bariatric surgery population has been reported to be anywhere between 35% and 94%. 3 One study that performed polysomnography (PSG) on all patients before bariatric surgery found an OSA rate of 47%. 4 Thus, the actual prevalence of OSA may be higher than some estimates due to patients with undiagnosed OSA.Sleep-disordered breathing (SDB), which leads to a higher rate of pulmonary and cardiovascular complications in the postoperative period, is common in patients with obesity. 5 Examining the significance of OSA as a comorbidity in patients undergoing bariatric surgical procedures is of special interest due to the strong association between OSA and obesity. The majority of weight loss surgeries are performed using a minimally invasive laparoscopic approach, which has a lower complication rate compared with open procedures. 6 To minimize morbidity and mortality and optimize resource utilization, it is appropriate to determine the ideal preoperative screening tests, intraoperative management, and postoperative monitoring techniques for patients with OSA undergoing bariatric surgery.

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“…In this technique, after debridement of the fistula margins, a Roux limb is fashioned to the fistula, followed by the creation of a jejunojejunostomy. This allows for the creation of a low-pressure system with a closed system for the leak [22] . Management options are complex, and the decision to abort continued endoscopic intervention in favor of revisional surgery should be discussed on a case-by-case basis with the involvement of a multidisciplinary team.…”

Section: Leakmentioning

confidence: 99%

Revisional bariatric surgery: a review of workup and management of common complications after bariatric surgery

Lyons¹,

Omar²,

Tholey³

et al. 2022

MIS

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With the rising prevalence of obesity, there has been a steady rise in the number of bariatric surgeries performed worldwide. As expected, there has also been an increase in the number of revisional surgeries performed to manage acute and chronic postoperative complications. This review will discuss the major complications that can arise from the most common bariatric surgeries, their diagnosis, medical management, and potential revisional surgical options.

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Predictors and outcomes of bleed after sleeve gastrectomy: an analysis of the MBSAQIP data registry

Cited by 47 publications

References 18 publications

Safety of Single Stage Revision Laparoscopic Sleeve Gastrectomy Compared to Laparoscopic Roux-Y Gastric Bypass after Failed Gastric Banding

Safety of Single Stage Revision Laparoscopic Sleeve Gastrectomy Compared to Laparoscopic Roux-Y Gastric Bypass after Failed Gastric Banding

Bariatric surgery in patients with obstructive sleep apnea

Revisional bariatric surgery: a review of workup and management of common complications after bariatric surgery

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