Prevention and management of postoperative hemorrhage after laparoscopic Roux-en-Y gastric bypass

doi:10.3877/cma.j.issn.2095-9605.2022.02.001

Abstract

Abstract:

In recent years, bariatric surgery has developed rapidly, and its surgical procedures are constantly being innovated. But the postoperative complications after laparoscopic Roux-en-Y gastric bypass (LRYGB) are not rare, among which hemorrhage is one of the most serious complications after LRYGB, with an increased risk of serious adverse events such as perioperative reoperation and death.Therefore, identifying postoperative hemorrhage timely and taking effective measures promptly according to the clinical context are the keys to reducing the treatment cycle, and avoiding adverse events. This review article aims to conclude risks factors, causes, preventive measures and means of treatment for postoperative hemorrhage after LRYGB.

Key words: Laparoscopic Roux-en-Y gastric bypass, Hemorrhage, Complication, Risks factors

Wen Zhao, Wenxing Gao, Dingchang Li, Lujia Jin, Peng Chen, Xiansheng Wu, Guanglong Dong. Prevention and management of postoperative hemorrhage after laparoscopic Roux-en-Y gastric bypass[J]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2022, 08(02): 73-78.

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References 27

[1]	Acquafresca PA, Palermo M, Rogula T, et al. Early surgical complications after gastric by-pass: a literature review [J]. Arq Bras Cir Dig, 2015, 28(1): 74-80.
[2]	Simillis C, Fachiri M, Bonanomi G. A challenging gastrointestinal hemorrhage after gastric bypass treated with interventional radiology [J]. Surg Obes Relat Dis, 2016, 12(7): e59-e62.
[3]	Bakhos C, Alkhoury F, Kyriakides T, et al. Early postoperative hemorrhage after open and laparoscopic roux-en-y gastric bypass [J]. Obes Surg, 2009, 19(2): 153-157.
[4]	Fecso AB, Samuel T, Elnahas A, et al. Clinical Indicators of Postoperative Bleeding in Bariatric Surgery[J]. Surg Laparosc Endosc Percutan Tech, 2018, 28(1): 52-55.
[5]	Susmallian S, Danoch R, Raskin B, et al. Assessing Bleeding Risk in Bariatric Surgeries: A Retrospective Analysis Study [J]. Dig Dis, 2020, 38(6): 449-457.
[6]	Finks JF, Kole KL, Yenumula PR, et al. Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative [J]. Ann Surg, 2011, 254(4): 633-640.
[7]	Pereira A, Santos RF, Costa-Pinho A, et al. Early Postoperative Bleeding After Laparoscopic Roux-En-Y Gastric Bypass: a Single Center Analysis [J]. Obes Surg, 2022, 32(6): 1902-1908.
[8]	Janik MR, Aryaie AH. The effect of smoking on bariatric surgical 30-day outcomes: propensity-score-matched analysis of the MBSAQIP [J]. Surg Endosc, 2021, 35(7): 3905-3914.
[9]	Zafar SN, Miller K, Felton J, et al. Postoperative bleeding after laparoscopic Roux en Y gastric bypass: predictors and consequences [J]. Surg Endosc, 2019, 33(1): 272-280.
[10]	Sharma G, Hanipah ZN, Aminian A, et al. Bariatric Surgery in Patients on Chronic Anticoagulation Therapy [J]. Obes Surg, 2018, 28(8): 2225-2232.
[11]	Nguyen NT, Wolfe BM. The physiologic effects of pneumoperitoneum in the morbidly obese [J]. Ann Surg, 2005, 241(2): 219-226.
[12]	Umar A, Mehta KS, Mehta N. Evaluation of hemodynamic changes using different intra-abdominal pressures for laparoscopic cholecystectomy [J]. Indian J Surg, 2013, 75(4): 284-289.
[13]	Pyke O, Yang J, Cohn T, et al. Marginal ulcer continues to be a major source of morbidity over time following gastric bypass [J]. Surg Endosc, 2019, 33(10): 3451-3456.
[14]	Süsstrunk J, Wartmann L, Mattiello D, et al. Incidence and Prognostic Factors for the Development of Symptomatic and Asymptomatic Marginal Ulcers After Roux-en-Y Gastric Bypass Procedures [J]. Obes Surg, 2021, 31(7): 3005-3014.
[15]	Rodrigo DC, Jill S, Daniel M, et al. Which Factors Correlate with Marginal Ulcer After Surgery for Obesity? [J]. Obes Surg, 2020, 30(12): 4821-4827.
[16]	Mocanu V, Dang JT, Switzer N, et al. The Effect of Helicobacter pylori on Postoperative Outcomes in Patients Undergoing Bariatric Surgery: a Systematic Review and Meta-analysis [J]. Obes Surg, 2018, 28(2): 567-573.
[17]	Heneghan HM, Meron-Eldar S, Yenumula P, et al. Incidence and management of bleeding complications after gastric bypass surgery in the morbidly obese [J]. Surg Obes Relat Dis, 2012, 8(6): 729-735.
[18]	Rabl C, Peeva S, Prado K, et al. Early and late abdominal bleeding after Roux-en-Y gastric bypass: sources and tailored therapeutic strategies [J]. Obes Surg, 2011, 21(4): 413-420.
[19]	Shikora SA, Mahoney CB. Clinical Benefit of Gastric Staple Line Reinforcement (SLR) in Gastrointestinal Surgery: a Meta-analysis [J]. Obes Surg, 2015, 25(7): 1133-1141.
[20]	Borjas G, Gonzalez M, Maldonado A, et al. Oversewing staple line of the gastric remnant in gastric bypass reduces postoperative bleeding [J]. Ann Med Surg (Lond), 2021, 67: 102534.
[21]	Alasfar F, Chand B. Intraoperative endoscopy for laparoscopic Roux-en-Y gastric bypass: leak test and beyond [J]. Surg Laparosc Endosc Percutan Tech, 2010, 20(6): 424-427
[22]	中国研究型医院学会糖尿病与肥胖外科专业委员会. 减重与代谢外科加速康复外科原则中国专家共识(2021版) [J/CD]. 中华肥胖与代谢病电子杂志, 2021, 7(03): 141-145.
[23]	胡瑞翔，杨景哥，杨华, 等. 450例腹腔镜Roux-en-Y胃旁路术后并发症的分析及处理 [J]. 中华消化外科杂志, 2017, 16(06): 582-586.
[24]	王勇，张旭. 减重及代谢疾病病人围手术期静脉血栓栓塞症预防[J]. 中国实用外科杂志, 2017, 37(02): 129-132.
[25]	Odutayo A, Desborough MJ, Trivella M, et al. Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials [J]. Lancet Gastroenterol Hepatol, 2017, 2(5): 354-360.
[26]	Marmo R, Rotondano G, Piscopo R, et al. Dual therapy versus monotherapy in the endoscopic treatment of high-risk bleeding ulcers: a meta-analysis of controlled trials [J]. Am J Gastroenterol, 2007, 102(2): 279-289.
[27]	Chahal D, Sidhu H, Zhao B, et al. Efficacy of Hemospray (TC-325) in the Treatment of Gastrointestinal Bleeding: An Updated Systematic Review and Meta-analysis [J]. J Clin Gastroenterol, 2021, 55(6): 492-498.

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