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Obesity Surgery

, Volume 17, Issue 9, pp 1261–1267 | Cite as

Endoscopic hemostasis using endoclip in early gastrointestinal hemorrhage after gastric bypass surgery

  • Shou-Jiang Tang
  • Homero Rivas
  • Linda Tang
  • Luis F. Lara
  • Jayaprakash Sreenarasimhaiah
  • Don C. Rockey
Case Reports

Abstract

Roux-en-Y gastric bypass (RYGBP) is the most commonly performed bariatric operation in the USA. In the early postoperative stage, gastrointestinal (GI) bleeding is an infrequent but potentially serious complication that usually results from bleeding at the gastroje-junostomy staple-line. Observant management with transfusion for stable patients and surgical exploration for unstable patients is typically recommended for early GI bleeding. We hypothesized that use of endoclips, which do not cause thermal injury to the surrounding tissues (or anastomosis), may be preferable to thermal approaches which could cause tissue injury. We report 2 cases of early GI bleeding after RYGBP that were successfully managed with endoclip application to bleeding lesions. Emergent endoscopy was performed, and major stigmata such as active spurting vessel and adherent clot were noted at the gastrojejunostomy staple-lines. Endoscopic hemostasis using endoclips was readily applied to bleeding lesions at staple-lines. Primary hemostasis was achieved, and there was no recurrent bleeding or complication. We conclude that therapeutic endoscopy can be performed safely for early bleeding after RYGBP. In patients with early bleeding after RYGBP, use of endoclips is mechanistically preferable to other options.

Key words

Morbid obesity bariatric surgery Roux-en-Y gastric bypass postoperative complications hemorrhage endoclip hemostasis 

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Copyright information

© Springer 2007

Authors and Affiliations

  • Shou-Jiang Tang
    • 1
  • Homero Rivas
    • 2
  • Linda Tang
    • 1
  • Luis F. Lara
    • 1
  • Jayaprakash Sreenarasimhaiah
    • 1
  • Don C. Rockey
    • 1
  1. 1.Division of Digestive and Liver Diseases, Department of Internal MedicineUT Southwestern Medical CenterUSA
  2. 2.Department of SurgeryUT Southwestern Medical CenterDallasUSA

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