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Obesity Surgery

, Volume 25, Issue 9, pp 1711–1715 | Cite as

Intraoperative Endoscopy Decreases Postoperative Complications in Laparoscopic Roux-en-Y Gastric Bypass

  • Mohammed Al Hadad
  • Nidal Dehni
  • Doua Elamin
  • Maha Ibrahim
  • Shadin Ghabra
  • Abdelrahman NimeriEmail author
Original Contributions

Abstract

Background

Leak or stenosis following laparoscopic Roux-en-Y gastric bypass (LRYGB) can lead to a major morbidity. We aim to evaluate whether the routine use of intraoperative endoscopy (IOE) can reduce this morbidity.

Methods

All cases of LRYGB in 2009–2014 were reviewed. In all cases, we perform an IOE. If IOE shows a leak, the area of the leak is re-enforced and IOE is repeated. If the leak persisted, a feeding tube and drains are placed.

Results

During the study period, we performed 342 LRYGB cases. Primary LRYGB represented 82 % (282/342). Average BMI 48 kg/m2 (range was 35–92) and females represented 76 % (261/342). Our clinical leak rate was 3/342 (0.88 %) in LRYGB (0.4 % in primary and 3.3 % in revisional LRYGB). IOE showed a positive air leak test in six LRYGB cases (1.75 %). We were able to achieve a negative leak test after re-enforcement in 5/6 (83 %) cases, and all those patients had no clinical leak. The patient with persistent air leak test had a clinical leak after surgery. IOE was negative in 336 LRYGB cases and we had two clinical leaks in this group (0.59 %). Our stenosis rate at the gastrojejunostomy was 3/342 (0.88 %). The positive predictive value (PPV) of the performing IOE to detect leaks in LRYGB was 75 % while the negative predictive value was 99.5 %.

Conclusions

Routine IOE has led to a change in the operative strategy and could be one reason for our low leak and stenosis in laparoscopic Roux-en-Y gastric bypass.

Keywords

Bariatric surgery LRYGB Intraoperative endoscopy Leak Stricture 

Notes

Conflict of Interest

Drs. Al Hadad, Dehni, Elamin, Ibrahim, Ghabra, and Nimeri have no conflicts of interest or financial ties to disclose. For this type of study, a formal consent is not required.

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Copyright information

© Springer Science+Business Media New York 2015

Authors and Affiliations

  • Mohammed Al Hadad
    • 1
  • Nidal Dehni
    • 1
  • Doua Elamin
    • 2
  • Maha Ibrahim
    • 1
  • Shadin Ghabra
    • 2
  • Abdelrahman Nimeri
    • 1
    Email author
  1. 1.BMI Abu DhabiSheikh Khalifa Medical CityAbu DhabiUnited Arab Emirates
  2. 2.General Surgery Residency Program of Abu Dhabi UAEAbu DhabiUnited Arab Emirates

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