Strategies for Conservative Management of Early Post-Operative Obstruction Following Roux-en-Y Gastric Bypass
- 05.09.2025
- Research
Erschienen in:
- Verfasst von
- Damien Lazar
- Avery Brown
- Jeffrey Lipman
- Eduardo Somoza
- John Saunders
- Patricia Chui
- Julia Park
- Peter Einersen
- Matthew Peacock
- Karan Chhabra
- Manish Parikh
- Erschienen in
- Obesity Surgery | Ausgabe 10/2025
Abstract
Background
Early postoperative small bowel obstruction (ESBO) following roux-en-Y gastric bypass (RYGB) is a feared complication, generally estimated to occur in 1–2% of cases. Most surgeons advocate for prompt surgical exploration for ESBO after RYGB. There is currently a paucity of literature regarding conservative management approaches to ESBO after RYGB.
Objectives
To determine the safety and efficacy of non-operative management of early small bowel obstruction following RYGB.
Setting
Academic-affiliated municipal hospital.
Methods
We performed a retrospective review of all patients at a single institution who underwent RYGB between July 1, 2020 and April 30, 2024 and were readmitted within 30 days of the procedure due to a small bowel obstruction. Mesenteric defects were closed with permanent suture in 100% of cases.
Results
2430 RYGBs were performed, 54 patients (2.2%) developed ESBO. The average interval from time of surgery to diagnosis of ESBO was 7.3 days [range 2–26 days]. The vast majority of patients (n = 43; 80%) were successfully managed conservatively including nasogastric decompression (n = 20; 47%). Most (73%) of the patients requiring reoperation were found to have kinking at the anastomosis or dense adhesions from the cut end of the staple line.
Conclusions
This study demonstrates that non-operative management may be a safe and effective treatment option for the majority of RYGB patients who develop ESBO. Clinical judgement is required to identify those who would benefit from early exploration.
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- Titel
- Strategies for Conservative Management of Early Post-Operative Obstruction Following Roux-en-Y Gastric Bypass
- Verfasst von
-
Damien Lazar
Avery Brown
Jeffrey Lipman
Eduardo Somoza
John Saunders
Patricia Chui
Julia Park
Peter Einersen
Matthew Peacock
Karan Chhabra
Manish Parikh
- Publikationsdatum
- 05.09.2025
- Verlag
- Springer US
- Erschienen in
-
Obesity Surgery / Ausgabe 10/2025
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428 - DOI
- https://doi.org/10.1007/s11695-025-08227-3
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