We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
Anastomotic Ulcer Perforation Following One Anastomosis Gastric Bypass.
- Authors
Abu-Abeid, Adam; Tome, Jawad; Lahat, Guy; Eldar, Shai Meron; Dayan, Danit
- Abstract
Perforated anastomotic ulcer after one anastomosis gastric bypass: Background: One anastomosis gastric bypass (OAGB) is a common bariatric metabolic surgery. Anastomotic ulcer (AU) perforation is a delayed complication, liable to cause sepsis and death. We present a cohort of twelve patients who underwent emergent surgery due to AU perforation. Materials and Methods: A retrospective analysis of a single center database of patients operated for AU perforation after OAGB (January 2015 to December 2021). Data retrieved included perioperative characteristics and postoperative outcomes. Results: The incidence of AU perforation among 1425 OAGB patients is 0.7%. AU perforation occurred after OAGB at a median time interval of 13 months (interquartile range (IQR) 5, 23). Eight patients had at least one risk factor for AU perforation. All patients presented with acute abdominal pain. Pneumoperitoneum was evident in ten patients on imaging studies. Surgery was laparoscopic in eleven patients, with one conversion to laparotomy. Operative findings were AU perforation, with a median perforation size of 5 mm (IQR 1.1, 18.7). Laparoscopic omentopexy ± primary AU repair, open omentopexy ± primary AU repair, and laparoscopic conversion to Roux-en-Y gastric bypass were performed (n = 9, 2, 1 patients, respectively). Median length of stay was 7.5 days (IQR 5, 11.5). No major complications occurred. All patients are doing well at a median follow-up of 11.5 months (IQR 2.2, 19.2). Four out of seven smoking patients still smoke. Conclusion: AU perforation after OAGB mandates a high index of suspicion, prompt diagnosis, and surgical treatment. Laparoscopic omentopexy ± primary AU repair is feasible in most cases, safe, and confers good outcomes.
- Subjects
GASTRIC bypass; SURGICAL anastomosis; BARIATRIC surgery; ULCERS; ABDOMINAL pain; DIAGNOSTIC imaging
- Publication
Obesity Surgery, 2022, Vol 32, Issue 7, p2366
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-022-06088-8