Routine Gastrostomy Tube Placement in Gastric Bypass Patients: Impact on Length of Stay and 30-Day Readmission Rate
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Laparoscopic Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity. Current average length of hospital stay (LOS) after RYGB is 2–3 days and 30-day readmission rate is 8–13 %. The aim of our study is to evaluate the effect of routine gastrostomy tube placement in perioperative outcomes of RYGB patients.
Between January 2008 and December 2010, a total of 840 patients underwent RYGB at our institution. All RYGB patients had gastrostomy tube placed, which was kept for 6 weeks. A retrospective review of a prospectively collected database was performed for all RYGB patients, noting the outcomes and complications of the procedure.
Average LOS in our patient population was 1.1 days (range, 1–14 days), and 824 (98.3 %) patients were discharged on postoperative day 1. Readmissions within 30 days after the index RYGB was observed in 31 (3.7 %) patients. Reasons included abdominal pain (n = 14), nausea/vomiting (n = 6), gastrostomy tube-related complications (n = 5), chest pain (n = 3), allergic reaction (n = 1), urinary tract infection (n = 1), and dehydration (n = 1). Of these readmitted patients, nine (1.1 %) patients required reoperations due to small bowel obstruction (n = 5), perforated anastomotic ulcer (n = 1), anastomotic leak (n = 1), subphrenic abscess (n = 1), and appendicitis (n = 1).
Routine gastrostomy tube placement in the gastric remnant at the time of RYGB seems to have contributed to our short LOS and low 30-day readmission rate.
KeywordsGastric bypass Readmissions Reoperations Length of stay Gastrostomy tube