BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (RYGB) is a well-established procedure to treat morbid obesity. Gastrojejunal anastomotic (GJA) ulcers can develop after surgery with subsequent perforation. Our aim was to evaluate the incidence, presentation and outcome of management of perforated GJA ulcer disease after laparoscopic RYGB. METHODS: The database of all patients at the senior author's bariatric institutions was retrospectively reviewed. The results are presented as mean (range). RESULTS: From April 2002 to April 2010, 1213 patients underwent laparoscopic RYGB, which included 1184 primary and 29 revision procedures. The operative mortality was .15%. Ten patients developed perforated GJA ulcers (.82%) at a mean of 13.5 (6-19) months. The patients who presented to bariatric surgeons (n = 5) were treated with laparoscopic closure and an omental patch, and those who presented to nonbariatric surgeons (n = 5) were treated with laparotomy. The morbidity and mortality rate was 30% and 10%, respectively, and the mean postoperative hospital stay for the survivors was 14 (5-44) days. CONCLUSION: Perforated GJA ulcers can develop in 1 of 120 patients after laparoscopic RYGB and can be effectively managed by laparoscopic repair with an omental patch, if expertise is available.
BACKGROUND: Laparoscopic Roux-en-Y gastric bypass (RYGB) is a well-established procedure to treat morbid obesity. Gastrojejunal anastomotic (GJA) ulcers can develop after surgery with subsequent perforation. Our aim was to evaluate the incidence, presentation and outcome of management of perforated GJA ulcer disease after laparoscopic RYGB. METHODS: The database of all patients at the senior author's bariatric institutions was retrospectively reviewed. The results are presented as mean (range). RESULTS: From April 2002 to April 2010, 1213 patients underwent laparoscopic RYGB, which included 1184 primary and 29 revision procedures. The operative mortality was .15%. Ten patients developed perforated GJA ulcers (.82%) at a mean of 13.5 (6-19) months. The patients who presented to bariatric surgeons (n = 5) were treated with laparoscopic closure and an omental patch, and those who presented to nonbariatric surgeons (n = 5) were treated with laparotomy. The morbidity and mortality rate was 30% and 10%, respectively, and the mean postoperative hospital stay for the survivors was 14 (5-44) days. CONCLUSION: Perforated GJA ulcers can develop in 1 of 120 patients after laparoscopic RYGB and can be effectively managed by laparoscopic repair with an omental patch, if expertise is available.
Authors: Belinda De Simone; Luca Ansaloni; Massimo Sartelli; Yoram Kluger; Fikri M Abu-Zidan; Walter L Biffl; Arianna Heyer; Federico Coccolini; Gian Luca Baiocchi Journal: World J Emerg Surg Date: 2020-01-06 Impact factor: 5.469
Authors: Mark R Wendling; John G Linn; Kara M Keplinger; Dean J Mikami; Kyle A Perry; W Scott Melvin; Bradley J Needleman Journal: Surg Endosc Date: 2012-08-31 Impact factor: 4.584
Authors: Usha K Coblijn; Sjoerd M Lagarde; Steve M M de Castro; Sjoerd D Kuiken; Bart A van Wagensveld Journal: Obes Surg Date: 2015-05 Impact factor: 4.129
Authors: Usha K Coblijn; Amin B Goucham; Sjoerd M Lagarde; Sjoerd D Kuiken; Bart A van Wagensveld Journal: Obes Surg Date: 2014-02 Impact factor: 4.129