Small bowel obstruction following laparoscopic Roux-en-Y gastric bypass: is it always necessary to operate? A 5-year, high volume center experience

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dc.contributor.authorGabrielli, Mauricio
dc.contributor.authorJarry, Cristian
dc.contributor.authorHurtado, Sebastian
dc.contributor.authorAchurra, Pablo
dc.contributor.authorMunoz, Rodrigo
dc.contributor.authorQuezada, Nicolas
dc.contributor.authorCrovari, Fernando
dc.date.accessioned2025-01-20T22:14:32Z
dc.date.available2025-01-20T22:14:32Z
dc.date.issued2021
dc.description.abstractPurpose This study aims to describe the incidence, associated factors, etiology, and management of small bowel obstructions following laparoscopic Roux-en-Y gastric bypass (LRYGB). Methods A retrospective analysis was conducted between January 15 and December 19 using the surgery database of our hospital. Included LRYGB patients were those that evolved with a prolonged length of stay; readmission; emergency room consult; and re-intervention due to small bowel obstruction (SBO) related symptoms with compatible radiological or intraoperative findings. The LRYGB technique implied an antecolic alimentary limb reconstruction and systematic closure of mesenteric defects. Descriptive and analytical statistics were carried out, using a parametric or non-parametric approach as needed. Results Nine hundred forty-one LRYGB were performed. 9.9% were revisional surgeries of patients with a laparoscopic sleeve gastrectomy. During the study period, 36 SBOs occurred, representing 3.8% of operated patients, with no mortality. 58.3% had successful non-operative management, while 41.7% required surgical exploration, of which 73.3% were treated laparoscopically and 20% needed conversion to open surgery. Etiologies of SBO were jejuno-jejunostomy (JJO) related stenosis (22, 61.1%), internal hernias (6, 16.7%), adherences (3, 8.3%), and other diagnoses (5, 13.9%). Regarding JJO stenosis and internal hernias, median time to diagnosis was 8 days (IQR 7-11) and 12 months (IQR 8.7-16) respectively. Previous sleeve gastrectomy, age, or sex was not associated to the incidence of small bowel obstruction. Conclusions LRYGB is safe when performed by experienced surgeons. SBO due to internal hernias were scarce in this series. JJO stenosis could explain most cases of SBO; under this diagnosis, non-surgical management was successful frequently.
dc.description.funderDigestive Surgery Department
dc.fuente.origenWOS
dc.identifier.doi10.1007/s00423-021-02262-1
dc.identifier.eissn1435-2451
dc.identifier.issn1435-2443
dc.identifier.urihttps://doi.org/10.1007/s00423-021-02262-1
dc.identifier.urihttps://repositorio.uc.cl/handle/11534/94484
dc.identifier.wosidWOS:000673458400001
dc.issue.numero6
dc.language.isoen
dc.pagina.final1846
dc.pagina.inicio1839
dc.revistaLangenbecks archives of surgery
dc.rightsacceso restringido
dc.subjectSmall bowel obstruction
dc.subjectBariatric surgery
dc.subjectGastric bypass
dc.subject.ods03 Good Health and Well-being
dc.subject.odspa03 Salud y bienestar
dc.titleSmall bowel obstruction following laparoscopic Roux-en-Y gastric bypass: is it always necessary to operate? A 5-year, high volume center experience
dc.typeartículo
dc.volumen406
sipa.indexWOS
sipa.trazabilidadWOS;2025-01-12
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