Selective nonoperative management of leaks after gastric bypass: Lessons learned from 2675 consecutive patients

Annals of Surgery

Volumn 248, Issue 5, 2008, Pages 782-792

  Thodiyil, Paul A ^a   Yenumula, Panduranga ^b   Rogula, Tomasz ^c   Gorecki, Piotr ^a   Fahoum, Bashar ^a   Gourash, William ^d   Ramanathan, Ramesh ^d   Mattar, Samer G ^f   Shinde, Dilip ^e   Arena, Vincent C ^g   Wise, Leslie ^a   Schauer, Philip ^b  

^a NEW YORK METHODIST HOSPITAL   (United States)

^b MICHIGAN STATE UNIVERSITY   (United States)

^c LERNER RESEARCH INSTITUTE   (United States)

^d UNIVERSITY OF PITTSBURGH MEDICAL CENTER   (United States)

^e UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

^f INDIANA UNIVERSITY   (United States)

^g UNIVERSITY OF PITTSBURGH GRADUATE SCHOOL OF PUBLIC HEALTH   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

ANTIBIOTIC AGENT;

ABDOMINAL ABSCESS; ABDOMINAL DRAINAGE; ADULT; ANASTOMOSIS DEHISCENCE; ANASTOMOSIS LEAKAGE; ANTIBIOTIC THERAPY; ARTICLE; BARIUM MEAL; BILIARY TRACT DRAINAGE; BODY MASS; BODY WEIGHT; CLINICAL ARTICLE; CONSERVATIVE TREATMENT; CONTRAST ENHANCEMENT; FEMALE; GASTROJEJUNOSTOMY; HOSPITAL READMISSION; HUMAN; JEJUNOSTOMY; LENGTH OF STAY; MALE; MULTIPLE ORGAN FAILURE; OUTCOME ASSESSMENT; PERITONITIS; POSTOPERATIVE PERIOD; PRIORITY JOURNAL; ROUX Y ANASTOMOSIS; STOMACH BYPASS; STOMACH POUCH; SURGICAL MORTALITY; SURGICAL PATIENT; TREATMENT OUTCOME; TREATMENT PLANNING; WOUND DEHISCENCE; ALGORITHM; ANASTOMOSIS; APACHE; COMORBIDITY; LAPAROSCOPY; MIDDLE AGED; MORBID OBESITY; POSTOPERATIVE COMPLICATION; WOUND DRAINAGE;

ALGORITHMS; ANASTOMOSIS, SURGICAL; APACHE; BODY MASS INDEX; COMORBIDITY; DRAINAGE; FEMALE; GASTRIC BYPASS; HUMANS; LAPAROSCOPY; LENGTH OF STAY; MALE; MIDDLE AGED; OBESITY, MORBID; POSTOPERATIVE COMPLICATIONS;

EID: 56149096315     PISSN: 00034932     EISSN: 15281140     Source Type: Journal    
DOI: 10.1097/SLA.0b013e31818584aa     Document Type: Article

References (33)

1. Kuczmarski RJ, Flegal KM, Campbell SM, et al. Increasing prevalence of overweight among US adults. The National Health and Nutrition Examination Surveys, 1960 to 1991. JAMA. 1994;272:205-211.
2. Flegal KM, Carroll MD, Ogden CL, et al. Prevalence and trends in obesity among US adults, 1999-2000. JAMA. 2002;288:1723-1727.
3. Nguyen NT, Root J, Zainabadi K, et al. Accelerated growth of bariatric surgery with the introduction of minimally invasive surgery. Arch Surg. 2005;140:1198-1202; discussion 1203.
4. Steinbrook R. Surgery for severe obesity. N Engl J Med. 2004;350: 1075-1079.
5. Csendes A, Burdiles P, Burgos AM, et al. Conservative management of anastomotic leaks after 557 open gastric bypasses. Obes Surg. 2005;15: 1252-1256.
6. Fernandez AZ Jr, DeMaria EJ, Tichansky DS, et al. Experience with over 3,000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2003;18:193-197.
7. 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;10:509-513.
8. Schauer PR, Ikramuddin S, Gourash W, et al. Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Ann Surg. 2000; 232:515-529.
9. Benotti PN, Wood GC, Rodriguez H, et al. Perioperative outcomes and risk factors in gastric surgery for morbid obesity: a 9-year experience. Surgery. 2006;139:340-346.
10. DeMaria EJ, Sugerman HJ, Kellum JM, et al. Results of 281 consecutive total laparoscopic Roux-en-Y gastric bypasses to treat morbid obesity. Ann Surg. 2002;235:640-645; discussion 645-647.
11. Shikora SA, Kim JJ, Tarnoff ME, et al. Laparoscopic Roux-en-Y gastric bypass: results and learning curve of a high-volume academic program. Arch Surg. 2005;140:362-367.
12. Mason EE, Renquist KE, Jiang D. Perioperative risks and safety of surgery for severe obesity. Am J Clin Nutr. 1992;55(suppl 2):S573-S576.
13. Hamilton EC, Sims TL, Hamilton TT, et al. Clinical predictors of leak after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Surg Endosc. 2003;17:679-684.
14. Fernandez AZ Jr, Demaria EJ, Tichansky DS, et al. Multivariate analysis of risk factors for death following gastric bypass for treatment of morbid obesity. Ann Surg. 2004;239:698-702; discussion 702-703.
15. Carucci LR, Turner MA, Conklin RC, et al. Roux-en-Y gastric bypass surgery for morbid obesity: evaluation of postoperative extraluminal leaks with upper gastrointestinal series. Radiology. 2006;238:119-127.
16. Cameron JL, Kieffer RF, Hendrix TR, et al. Selective nonoperative management of contained intrathoracic esophageal disruptions. Ann Thorac Surg. 1979;27:404-408.
17. Schauer PR, Ikramuddin S, Hamad G, et al. Laparoscopic gastric bypass surgery: current technique. J Laparoendosc Adv Surg Tech A. 2003;13: 229-239.
18. Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. J Clin Epidemiol. 1992;45:613-619.
19. Levy MM, Fink MP, Marshall JC, et al. 2001 SCCM/ESICM/ACCP/ ATS/SIS International Sepsis De?nitions Conference. Intensive Care Med. 2003;29:530-538.
20. Knaus WA, Draper EA, Wagner DP, et al. APACHE II: a severity of disease classi?cation system. Crit Care Med. 1985;13:818-829.
21. Wagner DP, Draper EA, Abizanda Campos R, et al. Initial international use of APACHE. An acute severity of disease measure. Med Decis Making. 1984;4:297-313.
22. Pacelli F, Doglietto GB, Al?eri S, et al. Prognosis in intra-abdominal infections. Multivariate analysis on 604 patients. Arch Surg. 1996;131:641-645.
23. Grunau G, Heemken R, Hau T. Predictors of outcome in patients with postoperative intra-abdominal infection. Eur J Surg. 1996;162:619-625.
24. Levison MA, Zeigler D. Correlation of APACHE II score, drainage technique and outcome in postoperative intra-abdominal abscess. Surg Gynecol Obstet. 1991;172:89-94.
25. Kelman GR. Digital computer subroutine for the conversion of oxygen tension into saturation. J Appl Physiol. 1966;21:1375-1376.
26. Severinghaus JW. Simple, accurate equations for human blood O2 dissociation computations. J Appl Physiol. 1979;46:599-602.
27. Wettstein RB, Shelledy DC, Peters JI. Delivered oxygen concentrations using low-?ow and high-?ow nasal cannulas. Respir Care. 2005;50: 604-609.
28. Arteaga JR, Huerta S, Livingston EH. Management of gastrojejunal anastomotic leaks after Roux-en-Y gastric bypass. Am Surg. 2002;68: 1061-1065.
29. Merri?eld BF, Lautz D, Thompson CC. Endoscopic repair of gastric leaks after Roux-en-Y gastric bypass: a less invasive approach. Gastrointest Endosc. 2006;63:710-714.
30. Garcia-Caballero M, Carbajo M, Martinez-Moreno JM, et al. Drain erosion and gastro-jejunal ?stula after one-anastomosis gastric bypass: endoscopic occlusion by ?brin sealant. Obes Surg. 2005;15:719-722.
31. Chousleb E, Szomstein S, Podkameni D, et al. Routine abdominal drains after laparoscopic Roux-en-Y gastric bypass: a retrospective review of 593 patients. Obes Surg. 2004;14:1203-1207.
32. Sera?ni F, Anderson W, Ghassemi P, et al. The utility of contrast studies and drains in the management of patients after Roux-en-Y gastric bypass. Obes Surg. 2002;12:34-38.
33. Chen LM, Martin CM, Morrison TL, et al. Interobserver variability in data collection of the APACHE II score in teaching and community hospitals. Crit Care Med. 1999;27:1999-2004.