Laparoscopic management of complications following laparoscopic Roux-en-Y gastric bypass for morbid obesity

• Published in: Surgical endoscopy Vol. 17; no. 4; pp. 610 - 614
• Main Authors: PAPASAVAS, P. K, CAUSHAJ, P. F, MCCORMICK, J. T, QUINLIN, R. F, HAYETIAN, F. D, MAURER, J, KELLY, J. J, GAGNE, D. J
• Format: Conference Proceeding Journal Article
• Language: English
• Published: New York, NY Springer 01-04-2003; Springer Nature B.V
• Subjects: Adult; Anastomosis, Roux-en-Y - adverse effects; Anastomosis, Roux-en-Y - methods; Biological and medical sciences; Body Mass Index; Endoscopy; Female; Gastric Bypass - adverse effects; Gastric Bypass - methods; Gastrointestinal surgery; Hernias; Hospitals; Humans; Intestinal obstruction; Laparoscopy; Laparoscopy - adverse effects; Laparotomy; Male; Medical sciences; Middle Aged; Obesity; Obesity, Morbid - surgery; Ostomy; Patients; Postoperative Complications; Sepsis; Stomach, duodenum, intestine, rectum, anus; Surgeons; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases; Surgery of the digestive system; Surgical anastomosis; Treatment Outcome; New York; United States > US; Human; Endoscopic surgery; Stomach; Obesity; Roux-en-Y gastric bypass; Digestive system; Nutrition disorder; Bariatric surgery; Roux en Y loop; Laparoscopy; Treatment; Bypass; Complication; Endoscopy; Laparoscopic Morbid obesity; Nutritional status; Bibliographic review
• ISSN: 0930-2794; 1432-2218
• DOI: 10.1007/s00464-002-8826-6

We reviewed our experience with complications following laparoscopic Roux-en-Y gastric bypass (LRYGB) that were managed laparoscopically.
A total of 246 consecutive morbidly obese patients (mean body mass index, 50.9 kg/m2) underwent LRYGB by three surgeons at two institutions. All patients met National Institutes of Health criteria for surgical treatment of morbid obesity. Patients were followed prospectively.
A total of 62 patients (25.2%) developed 64 complications, 34 of which (13.8%) required a surgical intervention. Twenty-seven of the 34 procedures were performed laparoscopically. Gastrojejunostomy stricture was the most common complication (8.9%), followed by intestinal obstruction (7.3%) and gastrointestinal bleeding (4%). The intestinal obstruction was secondary to adhesions (n = 6), internal hernia at the level of the transverse mesocolon (n = 3), jejunojejunostomy stricture (n = 3), and cicatrix around the Roux limb at the level of the transverse mesocolon (n = 3). Other complications included gastrojejunostomy leak (1.6%), symptomatic gallstone disease (2.8%), and gastric remnant perforation (0.8%). One patient underwent a negative laparoscopy to rule out anastomotic leak. There were 3 deaths in this series of patients, 2 attributable to anastomotic leak.
A variety of complications can present after LRYGB. Laparoscopy is an excellent technique to treat these complications.