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Obesity Surgery

, Volume 22, Issue 6, pp 855–862 | Cite as

Classification and Management of Leaks after Gastric Bypass for Patients with Morbid Obesity: A Prospective Study of 60 Patients

  • Attila Csendes
  • Ana Maria Burgos
  • Italo Braghetto
Clinical Report

Abstract

The most important and frequent major complication after gastric bypass is the appearance of a leak, which can result in death of a patient. The purpose of this prospective study was to determine the incidence of a postoperative leak, to propose a classification and to evaluate the results of conservative or surgical treatment. All patients submitted to gastric bypass either laparotomic or laparoscopic were included in a prospective protocol. In all radiological evaluation at 4th day after surgery was performed. The presence of a leak was evaluated according to the day of appearance, its location and its severity. Results of medical or surgical treatment were analyzed. From 1764 patients submitted to Roux-en-Y gastric bypass, 60 had a postoperative leak (3.4%). This leak appeared early after surgery (before 4 days) in 20%. It was a localized subclinical leak in 20% and clinical – septic in 80%. There were 7 possible anatomic location of a leak, being the gastrojejunal anastomosis the most frequent location (53%) followed by gastric pouch. The highest mortality was associated to the jejuno-jejunal anastomosis. Conservative treatment was employed in near 65% of the patients: The mean time of closure of a leak was 34 days. The appearance of a postoperative leak is a major and serious complication. It can be classified according to the day of appearance, its severity and its location. Conservative or surgical treatment can be employed properly if these 3 parameters are carefully evaluated.

Keywords

Methylene Blue Gastric Bypass Sleeve Gastrectomy Gastric Pouch Barium Sulfate 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Conflicts of interest

The authors declare that they have no conflict of interest.

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Copyright information

© Springer Science + Business Media, LLC 2011

Authors and Affiliations

  • Attila Csendes
    • 1
  • Ana Maria Burgos
    • 1
  • Italo Braghetto
    • 1
  1. 1.Department of Surgery, Hospital J.J. AguirreUniversity HospitalSantiagoChile

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