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Emergencies in Bariatric Surgery: Highlights for the General Surgeon

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Minimally Invasive Bariatric and Metabolic Surgery

Abstract

Bariatric surgery is safely performed in specialized centers: complications are <1 % in almost all published experiences, with <0.35 % in some specialized centers, similar to cholecystectomy [1]. These complications are treated by the original bariatric center, where the required skills and knowledge are available. However, acute complications might require emergency treatment in a local district hospital [2–4].

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References

  1. Kremen AJ, Linner JH, Nelson CH. An experimental evaluation of the nutritional importance of proximal and distal small intestine. Ann Surg. 1954;140(3):439–48.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  2. Boru C, Silecchia G. Bariatric emergencies: what the general surgeon should know. Chir (Bucur). 2010;105(4):455–64.

    CAS  Google Scholar 

  3. Kirshtein B, Lantsberg L, Mizrahi S, Avinoach E. Bariatric emergencies for non-bariatric surgeons: complications of laparoscopic gastric banding. Obes Surg. 2010;20(11):1468–78.

    Article  PubMed  Google Scholar 

  4. Monkhouse SJ, Morgan JD, Norton SA. Complications of bariatric surgery: presentation and emergency management—a review. Ann R Coll Surg Engl. 2009;91(4):280–6.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  5. Morrison LJ, Deakin CD, Morley PT, Callaway CW, Kerber RE, Kronick SL, Lavonas EJ, Link MS, Neumar RW, Otto CW, Parr M, Shuster M, Sunde K, Peberdy MA, Tang W, Hoek TL, Böttiger BW, Drajer S, Lim SH, Nolan JP; Advanced Life Support Chapter Collaborators. Part 8: Advanced life support: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science With Treatment Recommendations. Circulation. 2010; Oct 19;122 (16 Suppl 2):S345–421. doi:10.1161/CIRCULATIONAHA.110.971051.

  6. Böttiger BW, Drajer S, Lim SH, Nolan JP, Advanced Life Support Chapter Collaborators. Part 8: advanced life sup-port: 2010 International Consensus on Cardiopulmonary Resuscitation and Emergency Cardiovascular Care Science with Treatment Recommendations. Circulation. 2010;122(16 Suppl 2):S345–421.

    PubMed  Google Scholar 

  7. Sapala JA, Wood MH, SchuhKneckt MP, Sapal MA. Fatal pulmonary embolism after bariatric operations for morbid obesity: a 24 year retrospective analysis. Obes Surg. 2003;13:819–25.

    Article  PubMed  Google Scholar 

  8. Becattini C, Agnelli G, Manina G, Noya G, Rondelli F. Venous thromboembolism after laparoscopic bariatric surgery for morbid obesity: clinical burden and prevention. Surg Obes Relat Dis. 2012;8(1):108–15.

    Article  PubMed  Google Scholar 

  9. Smith MD, Patterson E, Wahed AS, Belle SH, Berk PD, Courcoulas AP, Dakin GF, Flum DR, Machado L, Mitchell JE, Pender J, Pomp A, Pories W, Ramanathan R, Schrope B, Staten M, Ude A, Wolfe BM. Thirty-day mortality after bariatric surgery: independently adjudicated causes of death in the longitudinal assessment of bariatric surgery. Obes Surg. 2011;21(11):1687–92.

    Article  PubMed Central  PubMed  Google Scholar 

  10. Gagnière J, Slim K. Don’t let obese patients be discharged with tachycardia after sleeve gastrectomy. Obes Surg. 2012;22(9):1519–20.

    Article  PubMed  Google Scholar 

  11. Loder WA. Airway management in the obese patient. Crit Care Clin. 2010;26(4):641–6.

    Article  PubMed  Google Scholar 

  12. Kristensen MS. Airway management and morbid obesity. Eur J Anaesthesiol. 2010;27(11):923–7.

    Article  PubMed  Google Scholar 

  13. Kazemi A, Frazier T, Cave M. Micronutrient-related neurologic complications following bariatric surgery. Curr Gastroenterol Rep. 2010;12(4):288–95.

    Article  PubMed  Google Scholar 

  14. Galvin R, Bråthen G, Ivashynka A, Hillbom M, Tanasescu R, Leone MA, EFNS. EFNS guidelines for diagnosis, therapy and prevention of Wernicke encephalopathy. Eur J Neurol. 2010;17(12):1408–18.

    Article  CAS  PubMed  Google Scholar 

  15. Manzanares W, Hardy G. Thiamine supplementation in the critically ill. Curr Opin Clin Nutr Metab Care. 2011;14(6):610–7.

    Article  CAS  PubMed  Google Scholar 

  16. Becker DA, Balcer LJ, Galetta SL. The neurological complications of nutritional deficiency following bariatric surgery. J Obes. 2012;2012:608534. doi:10.1155/2012/608534.

    Article  PubMed Central  PubMed  Google Scholar 

  17. O’Brien PE. Bariatric surgery: mechanisms, indications and outcomes. J Gastroenterol Hepatol. 2010;25(8):1358–65.

    Article  PubMed  Google Scholar 

  18. Silecchia G, Bacci V, Bacci S, Casella G, Rizzello M, Fioriti M, Basso N. Reoperation after laparoscopic adjustable gastric banding: analysis of a cohort of 500 patients with long-term follow-up. Surg Obes Relat Dis. 2008;4(3):430–6.

    Article  PubMed  Google Scholar 

  19. Spivak H, Abdelmelek MF, Beltran OR, Ng AW, Kitahama S. Long-term outcomes of laparoscopic adjustable gastric banding and laparoscopic Roux-en-Y gastric bypass in the United States. Surg Endosc. 2012;26(7):1909–19.

    Article  PubMed  Google Scholar 

  20. Himpens J, Cadière GB, Bazi M, Vouche M, Cadière B, Dapri G. Long-term outcomes of laparoscopic adjustable gastric banding. Arch Surg. 2011;146(7):802–7.

    Article  PubMed  Google Scholar 

  21. Bueter M, Maroske J, Thalheimer A, Gasser M, Stingl T, Heimbucher J, Meyer D, Fuchs K-H, Fein M. Short- and long-term results of laparoscopic gastric banding for morbid obesity. Langenbecks Arch Surg. 2008;393(2):199–205.

    Article  PubMed  Google Scholar 

  22. Angrisani L, Furbetta F, Doldi S, Basso N, Lucchese M, Giacomelli F, Zappa M, Cosmo L, Veneziani A, Turicchia G, et al. Lap Band® adjustable gastric banding system. Surg Endosc. 2003;17(3):409–12.

    Article  CAS  PubMed  Google Scholar 

  23. Iannelli A, Facchiano E, Sejor E, Baqué P, Piche T, Gugenheim J. Gastric necrosis: a rare complication of gastric banding. Obes Surg. 2005;15(8):1211–4.

    Article  PubMed  Google Scholar 

  24. Landen S, Majerus B, Delugeau V. Complications of gastric banding presenting to the ED. Am J Emerg Med. 2005;23(3):368–70.

    Article  PubMed  Google Scholar 

  25. Campbell NA, Brown WA, Smith AI, Skinner S, Nottle P. Small bowel obstruction creates a closed loop in patients with a laparoscopic adjustable gastric band. Obes Surg. 2008;18(10):1346–9.

    Article  PubMed  Google Scholar 

  26. Egberts K, Brown WA, O’Brien PE. Systematic review of erosion after laparoscopic adjustable gastric banding. Obes Surg. 2011;21(8):1272–9.

    Article  PubMed  Google Scholar 

  27. Aurora AR, Khaitan L, Saber AA. Sleeve gastrectomy and the risk of leak: a systematic analysis of 4,888 patients. Surg Endosc. 2012;26(6):1509–15.

    Article  PubMed  Google Scholar 

  28. Tan JT, Kariyawasam S, Wijeratne T, Chandraratna HS. Diagnosis and management of gastric leaks after laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg. 2010;20(4):403–9.

    Article  PubMed  Google Scholar 

  29. Parkish M, Issa R, McCrillis A, Saunders JK, Ude-Wecome A, Gagner M. Strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257(2):231–7.

    Article  Google Scholar 

  30. Csendes A, Burgos AM, Braghetto I. Classification and management of leaks after gastric bypass for patients with morbid obesity: a prospective study of 60 patients. Obes Surg. 2012;22(6):855–62.

    Article  PubMed  Google Scholar 

  31. Bruce J, Krukowski ZH, Al-Khairy G, Russell EM, Park KG. Systematic review of the definition and measurement of anastomotic leak after gastrointestinal surgery. Br J Surg. 2001;88:1157–68.

    Article  CAS  PubMed  Google Scholar 

  32. Ballesta C, Berindoague R, Cabrera M, Palau M, Gonzales M. Management of anastomo tic leaks after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2008;18(6):623–30.

    Article  PubMed  Google Scholar 

  33. Yurcisin BM, DeMaria EJ. Management of leak in the bariatric gastric bypass patient: reoperate, drain and feed distally. J Gastrointest Surg. 2009;13(9):1564–6.

    Article  PubMed  Google Scholar 

  34. Morales MP, Miedema BW, Scott JS, De la Torre RA. Management of postsurgical leaks in the bariatric patient. Gastrointest Endosc Clin N Am. 2011;21(2):295–304.

    Article  PubMed  Google Scholar 

  35. Eubanks S, Edwards CA, Fearing NM, Ramaswamy A, De la Torre RA, Thaler KJ, Miedema BW, Scott JS. Use of endoscopic stents to treat anastomotic complications after bariatric surgery. J Am Coll Surg. 2008;206(5):935–8.

    Article  PubMed  Google Scholar 

  36. Bendewald FP, Choi JN, Blythe LS, Selzer DJ, Ditslear JH, Mattar SG. Comparison of hand-sewn, linear-stapled, and circular-stapled gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2011;21(11):1671–5.

    Article  PubMed  Google Scholar 

  37. Scopinaro N, Marinari G, Camerini G, Papadia F, 2004 ABS Consensus Conference. Biliopancreatic diversion for obesity: state of the art. Surg Obes Relat Dis. 2005;1:317–28.

    Article  PubMed  Google Scholar 

  38. Cossu ML, Meloni GB, Alagna S, Tilocca PL, Pilo L, Profili S, Noya G. Emergency surgical conditions after biliopancreatic diversion. Obes Surg. 2007;17(5):637–41.

    Article  PubMed  Google Scholar 

  39. Silecchia G, Rizzello M, Casella G, Fioriti M, Soricelli E, Basso N. Two-stage laparoscopic biliopancreatic diversion with duodenal switch as treatment of high-risk super-obese patients: analysis of complications. Surg Endosc. 2009;23(5):1032–7.

    Article  CAS  PubMed  Google Scholar 

  40. Sacks BC, Mattar SG, Qureshi FG, Eid GM, Collins JL, Barinas-Mitchell EJ, Schauer PR, Ramanathan RC. Incidence of marginal ulcers and the use of absorbable anastomotic sutures in laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2011;2(1):11–6.

    Article  Google Scholar 

  41. Ruutiainen AT, Levine MS, Williams NN. Giant jejunal ulcers after Roux-en-Y gastric bypass. Abdom Imaging. 2008;33(5):575–8.

    Article  PubMed  Google Scholar 

  42. Maung AA, Johnson DC, Piper GL, Barbosa RR, Rowell SE, Bokhari F, Collins JN, Gordon JR, Ra JH, Kerwin AJ. Evaluation and management of small-bowel obstruction: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012;73(5 Suppl 4):S362–9.

    Article  PubMed  Google Scholar 

  43. Martin MJ, Beekley AC, Sebesta JA. Bowel obstruction in bariatric and nonbariatric patients: major differences in management strategies and outcome. Surg Obes Relat Dis. 2011;7(3):263–9.

    Article  PubMed  Google Scholar 

  44. Owens M, Barry M, Janjua AZ, Winter DC. A systematic review of laparoscopic port site hernias in gastrointestinal surgery. Surgeon. 2011;9(4):218–24.

    Article  CAS  PubMed  Google Scholar 

  45. Husain S, Ahmed AR, Johnson J, Boss T, O’Malley W. Small-bowel obstruction after laparoscopic Roux-en-Y gastricbypass: etiology, diagnosis, and management. Arch Surg. 2007;142(10):988–93.

    Article  PubMed  Google Scholar 

  46. Higa KD, Ho T, Boone KB. Internal hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment and prevention. Obes Surg. 2003;13:350–4.

    Article  PubMed  Google Scholar 

  47. Tucker ON, Escalante-Tattersfield T, Szomstein S, Rosenthal RJ. The ABC system: a simplified classification system for small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Obes Surg. 2007;17:1549–54.

    Article  PubMed  Google Scholar 

  48. Silecchia G, Boru CE, Mouiel J, Rossi M, Anselmino M, Morino M, Toppino M, Gaspari A, Gentileschi P, Tacchino R, Basso N. The use of fibrin sealant to prevent major complications following laparoscopic gastric bypass: results of a multicenter, randomized trial. Surg Endosc. 2008;22(11):2492–7.

    Article  PubMed  Google Scholar 

  49. Iannuccilli JD, Grand D, Murphy BL, Evangelista P, Roye GD, Mayo-Smith W. Sensitivity and specificity of eight CT signs in the preoperative diagnosis of internal mesenteric hernia following Roux-en-Y gastric bypass surgery. Clin Radiol. 2009;64(4):373–80.

    Article  CAS  PubMed  Google Scholar 

  50. Reddy SA, Yang C, McGinnis LA, Seggerman RE, Garza E, Ford 3rd KL. Diagnosis of transmesocolic internal hernia as a complication of retrocolic gastric bypass: CT imaging criteria. AJR Am J Roentgenol. 2007;189(1):52–5.

    Article  PubMed  Google Scholar 

  51. Onopchenko A. Radiological diagnosis of internal hernia after Roux-en-Y gastric bypass. Obes Surg. 2005;15(5):606–11.

    Article  PubMed  Google Scholar 

  52. Shwetambara P, Soto E, Merola S. Diagnosis and management of internal hernias after laparoscopic gastric bypass. Obes Surg. 2007;17:1498–502.

    Article  Google Scholar 

  53. Mason EE, Renquist KE, Huang YH, Jamal M, Samuel I. Causes of 30-day bariatric surgery mortality: with emphasis on bypass obstruction. Obes Surg. 2007;17:9–14.

    Article  PubMed  Google Scholar 

  54. Li VK, Pulido N, Fajnwaks P, Szomstein S, Rosenthal R, Martinez-Duartez P. Predictors of gallstone formation after bariatric surgery: a multivariate analysis of risk factors comparing gastric bypass, gastric banding, and sleeve gastrectomy. Surg Endosc. 2009;23(7):1640–4.

    Article  PubMed  Google Scholar 

  55. Ahmed AR, Husain S, Saad N, Patel NC, Waldman DL, O’Malley W. Accessing the common bile duct after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007;3(6):640–3.

    Article  PubMed  Google Scholar 

  56. Levitzky BE, Wassef WY. Endoscopic management in the bariatric surgical patient. Curr Opin Gastroenterol. 2010;26(6):632–9.

    Article  PubMed  Google Scholar 

  57. Ceppa FA, Gagné DJ, Papasavas PK, Caushaj PF. Laparoscopic transgastric endoscopy after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2006;3(1):21–4.

    Article  PubMed  Google Scholar 

  58. Dapri G, Himpens J, Buset M, Vasilikostas G, Ntounda R, Cadière GB. Video. Laparoscopic transgastric access to the common bile duct after Roux-en-Y gastric bypass. Surg Endosc. 2009;23(7):1646–8.

    Article  CAS  PubMed  Google Scholar 

  59. Mergener K, Kozarek RA, Traverso W. Intraoperative ERCP: case reports. Gastrointest Endosc. 2003;58:461–3.

    PubMed  Google Scholar 

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Authors and Affiliations

  1. General, Emergency and Mini-Invasive Surgery Unit, Largo Brambilla, 3, Florence, 50132, Italy

    Carlo Bergamini & Giovanni Alemanno

  2. Department of Surgery, Bariatric and Metabolic Surgery Unit, Azienda Sanitaria Firenze, Santa Maria Nuova Hospital, Piazza Santa Maria Nuova, 1, Florence, 50122, Italy

    Enrico Facchiano & Marcello Lucchese

Authors
  1. Carlo Bergamini
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  2. Giovanni Alemanno
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  3. Enrico Facchiano
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  4. Marcello Lucchese
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Corresponding author

Correspondence to Carlo Bergamini .

Editor information

Editors and Affiliations

  1. General and Emergency Surgery, Bariatric Surgery, Careggi University Hospital, Florence, Italy

    Marcello Lucchese

  2. Department of Surgery, Medical School, University of Genoa, Genoa, Italy

    Nicola Scopinaro

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Bergamini, C., Alemanno, G., Facchiano, E., Lucchese, M. (2015). Emergencies in Bariatric Surgery: Highlights for the General Surgeon. In: Lucchese, M., Scopinaro, N. (eds) Minimally Invasive Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-15356-8_26

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  • DOI: https://doi.org/10.1007/978-3-319-15356-8_26

  • Publisher Name: Springer, Cham

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  • Online ISBN: 978-3-319-15356-8

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