Abstract
Small bowel obstruction (SBO) after bariatric surgery is well documented. Although infrequent, it can be associated with considerable morbidity and mortality. The laparoscopic approach to Roux-en-Y gastric bypass (LRYGB) has gained widespread popularity for the treatment of morbid obesity since its first description in 1994. One of the theoretical advantages of a minimally invasive technique is reduced intraabdominal adhesions and, consequently, diminution in the incidence of SBO. However, the laparoscopic approach demonstrates a similar rate of obstruction to the open procedure. In this review, an electronic literature search was undertaken of Medline, Embase, and Cochrane databases for the period January 1990 to October 2006 on the history, presentation, clinical evaluation, preoperative diagnostic techniques, and management of SBO after LRYGB compared to the open approach.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Anonymous. Gastrointestinal surgery for severe obesity. NIH consensus development conference, March 25–7,1991. Nutrition 1996;12(6):397–404.
Maggard MA, Shugarman LR, Suttorp M, et al. Meta-analysis: surgical treatment of obesity. Ann Intern Med 2005;142(7):547–59.
Jones KB Jr, Afram JD, Benotti PN, et al. Open versus laparoscopic Roux-en-Y gastric bypass: a comparative study of over 25,000 open cases and the major laparoscopic bariatric reported series. Obes Surg 2006;16(6):721–7.
Rosenthal RJ, Szomstein S, Kennedy CI, et al. Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at the Bariatric Institute, Cleveland Clinic Florida. Obes Surg 2006;16(2):119–24.
Nguyen NT, Goldman C, Rosenquist CJ, et al. Laparoscopic versus open gastric bypass: a randomized study of outcomes, quality of life, and costs. Ann Surg 2001;234(3):279–89.
Higa KD, Boone KB, Ho T. Complications of the laparoscopic Roux-en-Y gastric bypass: 1,040 patients—what have we learned? Obes Surg 2000;10(6):509–13.
Higa KD, Boone KB, Ho T, Davies OG. Laparoscopic Roux-en-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients. Arch Surg 2000;135(9):1029–33.
Hwang RF, Swartz DE, Felix EL. Causes of small bowel obstruction after laparoscopic gastric bypass. Surg Endosc 2004;18(11):1631–5.
Cho M, Carrodeguas L, Pinto D, et al. Diagnosis and management of partial small bowel obstruction after laparoscopic antecolic antegastric Roux-en-Y gastric bypass for morbid obesity. J Am Coll Surg 2006;202(2):262–8.
Ukleja A, Stone RL. Medical and gastroenterologic management of the post-bariatric surgery patient. J Clin Gastroenterol 2004;38(4):312–21.
Higa KD, Ho T, Boone KB. Internal hernias after laparoscopic Roux-en-Y gastric bypass: incidence, treatment and prevention. Obes Surg 2003;13(3):350–4.
Podnos YD, Jimenez JC, Wilson SE, et al. Complications after laparoscopic gastric bypass: a review of 3464 cases. Arch Surg 2003;138(9):957–61.
Brolin RE. Laparoscopic verses open gastric bypass to treat morbid obesity. Ann Surg 2004;239(4):438–40.
Felsher J, Brodsky J, Brody F. Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Surgery 2003;134(3):501–5.
Champion JK, Williams M. Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2003;13(4):596–600.
Macgregor AM. Small bowel obstruction following gastric bypass. Obes Surg 1992;2(4):333–9.
Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am 1967;47(6):1345–51.
Nguyen NT, Silver M, Robinson M, et al. Result of a national audit of bariatric surgery performed at academic centers: a 2004 University Health System Consortium Benchmarking Project. Arch Surg 2006;141(5):445–9.
Wittgrove AC, Clark GW, Tremblay LJ. Laparoscopic gastric bypass, Roux-en-Y: preliminary report of five cases. Obes Surg 1994;4(4):353–7.
DeMaria EJ, Jamal MK. Surgical options for obesity. Gastroenterol Clin North Am 2005;34(1):127–42.
Shikora SA. Severe obesity: a growing health concern A.S.P.E.N. should not ignore. JPEN J Parenter Enteral Nutr 2005;29(4):288–97.
Alvarez-Leite JI. Nutrient deficiencies secondary to bariatric surgery. Curr Opin Clin Nutr Metab Care 2004;7(5):569–75.
Lynch RJ, Eisenberg D, Bell RL. Metabolic consequences of bariatric surgery. J Clin Gastroenterol 2006;40(8):659–68.
Nguyen NT, Huerta S, Gelfand D, et al. Bowel obstruction after laparoscopic Roux-en-Y gastric bypass. Obes Surg 2004;14(2):190–6.
Ali MR, Sugerman HJ, DeMaria EJ. Techniques of laparoscopic Roux-en-Y gastric bypass. Semin Laparosc Surg 2002;9(2):94–104.
Wittgrove AC, Clark GW. Laparoscopic gastric bypass, Roux-en-Y 500 patients: technique and results with a 360 month follow-up. Obes Surg 2000;10(3):233–9.
Brolin RE. The antiobstruction stitch in stapled Roux-en-Y enteroenterostomy. Am J Surg 1995;169(3):355–7.
Nguyen NT, Neuhaus AM, Ho HS, et al. A prospective evaluation of intracorporeal laparoscopic small bowel anastomosis during gastric bypass. Obes Surg 2001;11(2):196–9.
Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg 2000;232(4):515–29.
Lauter DM. Treatment of nonadhesive bowel obstruction following gastric bypass. Am J Surg 2005;189(5):532–5.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Tucker, O.N., Escalante-Tattersfield, T., Szomstein, S. et al. The ABC System: A Simplified Classification System for Small Bowel Obstruction After Laparoscopic Roux-en-Y Gastric Bypass. OBES SURG 17, 1549–1554 (2007). https://doi.org/10.1007/s11695-007-9273-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11695-007-9273-1