Obesity Surgery

, Volume 27, Issue 8, pp 1924–1928 | Cite as

The Utility of Diagnostic Laparoscopy in Post-Bariatric Surgery Patients with Chronic Abdominal Pain of Unknown Etiology

  • Mohammad Alsulaimy
  • Suriya Punchai
  • Fouzeyah A. Ali
  • Matthew Kroh
  • Philip R. Schauer
  • Stacy A. Brethauer
  • Ali AminianEmail author
Original Contributions



Chronic abdominal pain after bariatric surgery is associated with diagnostic and therapeutic challenges. The aim of this study was to evaluate the yield of laparoscopy as a diagnostic and therapeutic tool in post-bariatric surgery patients with chronic abdominal pain who had negative imaging and endoscopic studies.


A retrospective analysis was performed on post-bariatric surgery patients who underwent laparoscopy for diagnosis and treatment of chronic abdominal pain at a single academic center. Only patients with both negative preoperative CT scan and upper endoscopy were included.


Total of 35 post-bariatric surgery patients met the inclusion criteria, and all had history of Roux-en-Y gastric bypass. Twenty out of 35 patients (57%) had positive findings on diagnostic laparoscopy including presence of adhesions (n = 12), chronic cholecystitis (n = 4), mesenteric defect (n = 2), internal hernia (n = 1), and necrotic omentum (n = 1). Two patients developed post-operative complications including a pelvic abscess and an abdominal wall abscess. Overall, 15 patients (43%) had symptomatic improvement after laparoscopy; 14 of these patients had positive laparoscopic findings requiring intervention (70% of the patients with positive laparoscopy). Conversely, 20 (57%) patients required long-term medical treatment for management of chronic abdominal pain.


Diagnostic laparoscopy, which is a safe procedure, can detect pathological findings in more than half of post-bariatric surgery patients with chronic abdominal pain of unknown etiology. About 40% of patients who undergo diagnostic laparoscopy and 70% of patients with positive findings on laparoscopy experience significant symptom improvement. Patients should be informed that diagnostic laparoscopy is associated with no symptom improvement in about half of cases.


Bariatric surgery Diagnostic laparoscopy Abdominal pain Gastric bypass Complication Adhesion Internal hernia Endoscopy 


Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

For this type of study, formal consent is not required.


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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Mohammad Alsulaimy
    • 1
    • 2
  • Suriya Punchai
    • 1
    • 3
  • Fouzeyah A. Ali
    • 4
  • Matthew Kroh
    • 1
  • Philip R. Schauer
    • 1
  • Stacy A. Brethauer
    • 1
  • Ali Aminian
    • 1
    Email author
  1. 1.Bariatric and Metabolic Institute, Department of General SurgeryCleveland ClinicClevelandUSA
  2. 2.Department of Surgery & Urology, Al-Sabah Hospital, Ministry of HealthKuwaitKuwait
  3. 3.Department of Surgery, Faculty of MedicineKhon Kaen UniversityKhon KaenThailand
  4. 4.Imaging Institute, Cleveland ClinicClevelandUSA

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