Percutaneous Image-Guided Surgery in Complications After Bariatric Surgery

J Laparoendosc Adv Surg Tech A. 2020 Sep;30(9):967-972. doi: 10.1089/lap.2020.0410. Epub 2020 Jun 29.

Abstract

Background: Although bariatric surgery is a standardized procedure, it is not without complications. Image-guided surgery allows minimally invasive resolution of complications, making it ideal for bariatric patients. The objective of this work was to analyze the image-guided surgery approach to postoperative complications of bariatric surgery. Materials and Methods: Retrospective comparative study in patients with complications after bariatric surgery. Patients were included consecutively according to selection criteria. All the patients were treated by the same surgical team. Results: n = 58 patients were recruited. The average age was 47.3 (range 16-62) years; the distribution by sex was male 52% and female 48%. Average body mass index was 42% (±1.26). The associated comorbidities were diabetes mellitus 41% (±0.49), dyslipidemia 41% (±0.49), and high blood pressure 39% (±0.48). Of the total, 39 (67.2%) underwent laparoscopic sleeve gastrectomy (LSG) and 19 (32.8%) under Roux-en-Y Gastric Bypass (RYGB) (P ≥ .05). Complications reported were leaks/fistulas (with/without abdominal collections) in 94.8% (±0.22), gallstones 3.5% (±0.18), and hemorrhage 1.7% (±0.13). There was no statistically significant difference between the type of bariatric surgery (LSG versus RYGB) and the complications found (P ≥ .005). There were no intestinal obstructions, strictures or acute gastric dilations, or deaths. The treatment of complications was approached percutaneously (56.9%), endoscopically (29.4%), reoperation laparoscopically (12%), and clinical control (1.7%). Conclusion: The image-guided surgery approach to postoperative complications of bariatric surgery is feasible and safe. Good results are obtained with a decrease in the surgical comorbidities associated with the procedure.

Keywords: bariatric surgery; complications of bariatric surgery; image-guided surgery; percutaneous surgery.

Publication types

  • Comparative Study

MeSH terms

  • Adolescent
  • Adult
  • Anastomotic Leak / etiology
  • Anastomotic Leak / surgery*
  • Body Mass Index
  • Endoscopy, Gastrointestinal / methods
  • Female
  • Gallstones / etiology
  • Gallstones / surgery
  • Gastrectomy / adverse effects*
  • Gastrectomy / methods
  • Gastric Bypass / adverse effects*
  • Humans
  • Laparoscopy / methods
  • Male
  • Middle Aged
  • Obesity, Morbid / surgery
  • Postoperative Hemorrhage / etiology
  • Postoperative Hemorrhage / surgery*
  • Reoperation / methods
  • Retrospective Studies
  • Surgery, Computer-Assisted / methods*
  • Young Adult