PDF
Abstract
Gastrointestinal bleeding following bariatric surgery is a relatively rare adverse event but constitutes a significant cause of morbidity. It requires a high index of suspicion, early diagnosis, and prompt management, as it can lead to rapid deterioration and potential mortality. In most cases, GI bleeding is self-limited and does not necessitate emergent reoperation. For some patients, however, control of postoperative hemorrhage may require various procedural-based interventions via surgical, endoscopic, or radiologic approaches. Recent studies suggest that endoscopic therapies to manage intraluminal bleeding post-bariatric surgery are becoming increasingly popular given their high efficacy rate and favorable safety profile. Currently, there is no consensus on the management of early or late GI hemorrhage after metabolic surgery. Therefore, the aim of this review is to summarize the effectiveness of several treatment options and outline management algorithms for this subset of bariatric patients based on the established literature.
Keywords
Postoperative hemorrhage
/
bariatric surgery
/
GI bleeding
/
endoscopy
Cite this article
Download citation ▾
Spyridon Giannopoulos, Bhavani Pokala, Dimitrios Stefanidis.
Management of gastrointestinal bleeding following bariatric surgery.
Mini-invasive Surgery, 2022, 6(1): 22 DOI:10.20517/2574-1225.2021.135
| [1] |
Hales CM,Fryar CD.Prevalence of obesity and severe obesity among adults: United States, 2017-2018.NCHS Data Brief2020;360:1-8
|
| [2] |
Flum DR,King WC.Longitudinal Assessment of Bariatric Surgery (LABS) ConsortiumPerioperative safety in the longitudinal assessment of bariatric surgery.N Engl J Med2009;361:445-54 PMCID:PMC2854565
|
| [3] |
Sjöström CD,Wedel H.Reduction in incidence of diabetes, hypertension and lipid disturbances after intentional weight loss induced by bariatric surgery: the SOS intervention study.Obes Res1999;7:477-84
|
| [4] |
Murr M,Ajami H.Overview of emerging concepts in metabolic surgery.Perm J2010;14:57-62 PMCID:PMC2937847
|
| [5] |
Podnos YD,Wilson SE,Nguyen NT.Complications after laparoscopic gastric bypass: a review of 3464 cases.Arch Surg2003;138:957-61
|
| [6] |
Cai JX,Kumbhari V.Endoscopic management of bariatric surgery complications.Surg Laparosc Endosc Percutan Tech2016;26:93-101
|
| [7] |
ASMBS. Estimate of bariatric surgery numbers, 2011-2019. Available from: https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers [Last accessed on 12 Apr 2022]
|
| [8] |
Angrisani L,Iovino P.Bariatric surgery survey 2018: similarities and disparities among the 5 IFSO chapters.Obes Surg2021;31:1937-48 PMCID:PMC7800839
|
| [9] |
Kitahama S,Rosencrantz DR.Is bariatric surgery safe in patients who refuse blood transfusion?.Surg Obes Relat Dis2013;9:390-4
|
| [10] |
Augustin T,Romero-Talamás H.Reoperative surgery for management of early complications after gastric bypass.Obes Surg2016;26:345-9
|
| [11] |
Papasavas PK,Caushaj PF.Outcome analysis of laparoscopic Roux-En-Y gastric bypass for morbid obesity. The first 116 cases.Surg Endosc2002;16:1653-7
|
| [12] |
Nguyen NT,Wolfe BM.Early gastrointestinal hemorrhage after laparoscopic gastric bypass.Obes Surg2003;13:62-5
|
| [13] |
Fernández-Esparrach G,Pellisé M.Endoscopic management of early GI hemorrhage after laparoscopic gastric bypass.Gastrointest Endosc2008;67:552-5
|
| [14] |
Oliak D,Weber P.Laparoscopic Roux-en-Y gastric bypass: defining the learning curve.Surg Endosc2003;17:405-8
|
| [15] |
Sharma G,Boules M.Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass.Surgery2016;160:885-91
|
| [16] |
Jamil LH,Chengelis DL.Endoscopic management of early upper gastrointestinal hemorrhage following laparoscopic Roux-en-Y gastric bypass.Am J Gastroenterol2008;103:86-91
|
| [17] |
Papakonstantinou A,Stratopoulos C.Bleeding from the upper gastrointestinal tract after Mason’s vertical banded gastroplasty.Obes Surg2000;10:582-4
|
| [18] |
Pérez EM,Serrano P.Bleeding gastric pouch ulcer after vertical banded gastroplasty: a rare complication.Obes Surg1997;7:454
|
| [19] |
Iqbal M,Seenath M.Massive upper gastrointestinal hemorrhage: an unusual presentation after laparoscopic adjustable gastric banding due to erosion into the celiac axis.Obes Surg2008;18:759-60
|
| [20] |
Bakhos C,Kyriakides T,Nadzam G.Early postoperative hemorrhage after open and laparoscopic Roux-En-Y gastric bypass.Obes Surg2009;19:153-7
|
| [21] |
Alam M,Matthews JH.Mortality related to primary bariatric surgery in England.BJS Open2017;1:122-7 PMCID:PMC5989948
|
| [22] |
Smith MD,Wahed AS.Thirty-day mortality after bariatric surgery: independently adjudicated causes of death in the longitudinal assessment of bariatric surgery.Obes Surg2011;21:1687-92 PMCID:PMC3249614
|
| [23] |
ASMBS. Studies weigh in on safety and effectiveness of newer bariatric and metabolic surgery procedure. Available from: https://asmbs.org/resources/studies-weigh-in-on-safety-and- [Last accessed on 12 Apr 2022]
|
| [24] |
Behary J.Advances in the endoscopic management of obesity.Gastroenterol Res Pract2015;2015:757821 PMCID:PMC4461770
|
| [25] |
Ponce J,Swain J.REDUCE Pivotal Trial InvestigatorsThe REDUCE pivotal trial: a prospective, randomized controlled pivotal trial of a dual intragastric balloon for the treatment of obesity.Surg Obes Relat Dis2015;11:874-81
|
| [26] |
Singh S,Khan A.Safety and efficacy of endoscopic sleeve gastroplasty worldwide for treatment of obesity: a systematic review and meta-analysis.Surg Obes Relat Dis2020;16:340-51 PMCID:PMC7009311
|
| [27] |
Boules M,Haskins IN.Endoscopic management of post-bariatric surgery complications.World J Gastrointest Endosc2016;8:591-9 PMCID:PMC5027029
|
| [28] |
Spaw AT.Bleeding after laparoscopic gastric bypass: Case report and literature review.Surg Obes Relat Dis2005;1:99-103
|
| [29] |
Kaplan LM.Gastrointestinal management of the bariatric surgery patient.Gastroenterol Clin North Am2005;34:105-25
|
| [30] |
Bellorin O,Sucandy I,Rosenthal RJ.Understanding the significance, reasons and patterns of abnormal vital signs after gastric bypass for morbid obesity.Obes Surg2011;21:707-13
|
| [31] |
Ferreira LE,Baron TH.Management of acute postoperative hemorrhage in the bariatric patient.Gastrointest Endosc Clin N Am2011;21:287-94
|
| [32] |
Rao AD.Exsanguinating hemorrhage following gastric erosion after laparoscopic adjustable gastric banding.Obes Surg2006;16:1675-8
|
| [33] |
Fridman A, Szomstein S, Rosenthal RJ. Postoperative bleeding in the bariatric surgery patient.The ASMBS Textbook of Bariatric Surgery2015;21:241-7
|
| [34] |
Nguyen NT,Morton JM,Rosenthal RJ. The ASMBS textbook of bariatric surgery. Available from: https://link.springer.com/book/10.1007/978-3-030-27021-6?noAccess=true [Last accessed on 12 Apr 2022]
|
| [35] |
Córdova H.Treatment of bleeding after bariatric surgery.Techniques in Gastrointestinal Endoscopy2010;12:130-5
|
| [36] |
Kumar N.Endoscopic management of complications after gastrointestinal weight loss surgery.Clin Gastroenterol Hepatol2013;11:343-53
|
| [37] |
Cappell MS.Initial management of acute upper gastrointestinal bleeding: from initial evaluation up to gastrointestinal endoscopy.Med Clin North Am2008;92:491-509, xi
|
| [38] |
Baradarian R,Chapalamadugu R.Early intensive resuscitation of patients with upper gastrointestinal bleeding decreases mortality.Am J Gastroenterol2004;99:619-22
|
| [39] |
Heneghan HM,Yenumula P.Incidence and management of bleeding complications after gastric bypass surgery in the morbidly obese.Surg Obes Relat Dis2012;8:729-35
|
| [40] |
Campos JM,Teixeira A.Endoscopic management of massive hemorrhage 12 h post laparoscopic Roux-en-Y gastric bypass.Obes Surg2015;25:1981-3
|
| [41] |
Mehran A,Zundel N.Management of acute bleeding after laparoscopic Roux-en-Y gastric bypass.Obes Surg2003;13:842-7
|
| [42] |
Lim R,Johnson DC.Early and late complications of bariatric operation.Trauma Surg Acute Care Open2018;3:e000219 PMCID:PMC6203132
|
| [43] |
Rahman R,Sohail U.Pre-endoscopic erythromycin administration in upper gastrointestinal bleeding: an updated meta-analysis and systematic review.Ann Gastroenterol2016;29:312-7 PMCID:PMC4923816
|
| [44] |
Eisendrath P.Major complications of bariatric surgery: endoscopy as first-line treatment.Nat Rev Gastroenterol Hepatol2015;12:701-10
|
| [45] |
Huang CS.Endoscopy in the bariatric surgical patient.Gastroenterol Clin North Am2005;34:151-66
|
| [46] |
Kumbhari V,Schweitzer MA.Endoscopic management of bariatric surgical complications.Curr Opin Gastroenterol2015;31:359-67
|
| [47] |
Moretto M,Padoin AV,Repetto G.Endoscopic management of bleeding after gastric bypass -- a therapeutic alternative.Obes Surg2004;14:706
|
| [48] |
Tang SJ,Tang L.Endoscopic hemostasis using endoclip in early gastrointestinal hemorrhage after gastric bypass surgery.Obes Surg2007;17:1261-7
|
| [49] |
Issa H,Al-Momen S,Al-Salem A.Bleeding duodenal ulcer after Roux-en-Y gastric bypass surgery: the value of laparoscopic gastroduodenoscopy.Ann Saudi Med2010;30:67-9 PMCID:PMC2850185
|
| [50] |
Gill KR,Stark ME.Investigation of the excluded stomach after Roux-en-Y gastric bypass: the role of percutaneous endoscopy.World J Gastroenterol2008;14:1946-8 PMCID:PMC2700407
|
| [51] |
Anjiki H,Sanaka M,Kuyama Y.Endoscopic hemostasis techniques for upper gastrointestinal hemorrhage: a review.World J Gastrointest Endosc2010;2:54-60 PMCID:PMC2998874
|
| [52] |
Valli PV.Review article including treatment algorithm: endoscopic treatment of luminal complications after bariatric surgery.Clin Obes2017;7:115-22
|
| [53] |
Chuttani R,Carpenter S.Technology assessment committeeEndoscopic clip application devices.Gastrointest Endosc2006;63:746-50
|
| [54] |
Jensen DM,Hirabayashi K.Randomized controlled study of 3 different types of hemoclips for hemostasis of bleeding canine acute gastric ulcers.Gastrointest Endosc2006;64:768-73
|
| [55] |
Siegal SR.Endoscopic management of postoperative complications.Surg Clin North Am2020;100:1115-31
|
| [56] |
Hachisu T,Hamaguchi K.Endoscopic clip-marking of lesions using the newly developed HX-3L clip.Surg Endosc1989;3:142-7
|
| [57] |
Vanbiervliet G,Karimdjee BS.The role of clips in preventing migration of fully covered metallic esophageal stents: a pilot comparative study.Surg Endosc2012;26:53-9
|
| [58] |
Tang SJ,Gupta S.Endoclip closure of jejunal perforation after balloon dilatation.Obes Surg2007;17:540-3
|
| [59] |
Minami S,Ono H,Hamanaka H.Complete endoscopic closure of gastric perforation induced by endoscopic resection of early gastric cancer using endoclips can prevent surgery (with video).Gastrointest Endosc2006;63:596-601
|
| [60] |
Lin HJ,Tseng GY.A prospective, randomized trial of large- versus small-volume endoscopic injection of epinephrine for peptic ulcer bleeding.Gastrointest Endosc2002;55:615-9
|
| [61] |
Marmo R,Piscopo R.Dual therapy versus monotherapy in the endoscopic treatment of high-risk bleeding ulcers: a meta-analysis of controlled trials.Am J Gastroenterol2007;102:279-89; quiz 469
|
| [62] |
Vergara M,Gisbert JP.Epinephrine injection versus epinephrine injection and a second endoscopic method in high risk bleeding ulcers.Cochrane Database Syst Rev2014:CD005584
|
| [63] |
Lo CC,Lo GH.Comparison of hemostatic efficacy for epinephrine injection alone and injection combined with hemoclip therapy in treating high-risk bleeding ulcers.Gastrointest Endosc2006;63:767-73
|
| [64] |
Shi K,Zhu G,Gu M.Systematic review with network meta-analysis: dual therapy for high-risk bleeding peptic ulcers.BMC Gastroenterol2017;17:55 PMCID:PMC5395769
|
| [65] |
Kirschniak A,Stüker D.A new endoscopic over-the-scope clip system for treatment of lesions and bleeding in the GI tract: first clinical experiences.Gastrointest Endosc2007;66:162-7
|
| [66] |
Farnik H,Kratt T.Indication for “Over the scope” (OTS)-clip vs. covered self-expanding metal stent (cSEMS) is unequal in upper gastrointestinal leakage: results from a retrospective head-to-head comparison.PLoS One2015;10:e0117483
|
| [67] |
Schmidt A,Goetz M.Over-the-scope clips are more effective than standard endoscopic therapy for patients with recurrent bleeding of peptic ulcers.Gastroenterology2018;155:674-686.e6
|
| [68] |
Bartell N,Kaul V,Kothari S.Clinical efficacy of the over-the-scope clip device: a systematic review.World J Gastroenterol2020;26:3495-516 PMCID:PMC7327783
|
| [69] |
Wedi E,Menke D.One hundred and one over-the-scope-clip applications for severe gastrointestinal bleeding, leaks and fistulas.World J Gastroenterol2016;22:1844-53 PMCID:PMC4724615
|
| [70] |
Wedi E,Gonzalez S.Use of the over-the-scope-clip (OTSC) in non-variceal upper gastrointestinal bleeding in patients with severe cardiovascular comorbidities: a retrospective study.Endosc Int Open2017;5:E875-82 PMCID:PMC5595576
|
| [71] |
Manta R,Zullo A.First-line endoscopic treatment with over-the-scope clips in patients with either upper or lower gastrointestinal bleeding: a multicenter study.Endosc Int Open2018;6:E1317-21 PMCID:PMC6221819
|
| [72] |
Manno M,Caruso A.First-line endoscopic treatment with OTSC in patients with high-risk non-variceal upper gastrointestinal bleeding: preliminary experience in 40 cases.Surg Endosc2016;30:2026-9
|
| [73] |
Parsi MA.Hemospray for diffuse anastomotic bleeding.Gastrointest Endosc2014;80:1170
|
| [74] |
Chahal D,Ali-Mohamad N.High rate of re-bleeding after application of hemospray for upper and lower gastrointestinal bleeds.Dig Liver Dis2020;52:768-72
|
| [75] |
Chahal D,Zhao B.Efficacy of hemospray (TC-325) in the treatment of gastrointestinal bleeding: an updated systematic review and meta-analysis.J Clin Gastroenterol2021;55:492-8
|
| [76] |
Kantsevoy SV.Successful closure of a chronic refractory gastrocutaneous fistula with a new endoscopic suturing device (with video).Gastrointest Endosc2012;75:688-90
|
| [77] |
Armengol-Miro JR,Abu-Suboh Abadia M.New endoscopic suturing device for closure of chronic gastrocutaneous fistula in an immunocompromised patient.Endoscopy2011;43 Suppl 2 UCTN:E403-4
|
| [78] |
Kantsevoy SV,Davis JM.Endoscopic suturing closure of large iatrogenic colonic perforation.Gastrointest Endosc2015;82:754-5
|
| [79] |
Kantsevoy SV,Hajiyeva G.Endoscopic management of colonic perforations: clips versus suturing closure (with videos).Gastrointest Endosc2016;84:487-93
|
| [80] |
Kumar N.A novel method for endoscopic perforation management by using abdominal exploration and full-thickness sutured closure.Gastrointest Endosc2014;80:156-61 PMCID:PMC5019098
|
| [81] |
Bonin EA.Closure of a persistent esophagopleural fistula assisted by a novel endoscopic suturing system.Endoscopy2012;44 Suppl 2 UCTN:E8-9
|
| [82] |
Chon SH,Plum PS.Successful closure of a gastropulmonary fistula after esophagectomy using the apollo overstitch and endoscopic vacuum therapy.Endoscopy2018;50:E149-50
|
| [83] |
Bergström M,Park PO.Early clinical experience with a new flexible endoscopic suturing method for natural orifice transluminal endoscopic surgery and intraluminal endosurgery (with videos).Gastrointest Endosc2008;67:528-33
|
| [84] |
Agarwal A,Brewer Gutierrez OI.Endoscopic suturing for management of peptic ulcer-related upper gastrointestinal bleeding: a preliminary experience.Endosc Int Open2018;6:E1439-44 PMCID:PMC6288763
|
| [85] |
Barola S,Schweitzer M.Endoscopic suturing for massively bleeding marginal ulcer 10 days post Roux-en-Y gastric bypass.Obes Surg2017;27:1394-6
|
| [86] |
Astedt B.Clinical pharmacology of tranexamic acid.Scand J Gastroenterol Suppl1987;137:22-5
|
| [87] |
Cheriyan T,Bianco K.Efficacy of tranexamic acid on surgical bleeding in spine surgery: a meta-analysis.Spine J2015;15:752-61
|
| [88] |
Georgiadis AG,Silverton CD,Laker MW.A prospective double-blind placebo controlled trial of topical tranexamic acid in total knee arthroplasty.J Arthroplasty2013;28:78-82
|
| [89] |
Lin SY,Fu YC.The efficacy of combined use of intraarticular and intravenous tranexamic acid on reducing blood loss and transfusion rate in total knee arthroplasty.J Arthroplasty2015;30:776-80
|
| [90] |
Shakur H,Bautista R.Effects of tranexamic acid on death, vascular occlusive events, and blood transfusion in trauma patients with significant haemorrhage (CRASH-2): a randomised, placebo-controlled trial.Lancet2010;376:23-32
|
| [91] |
Chakravartty S,Chang A.Staple line bleeding in sleeve gastrectomy-a simple and cost-effective solution.Obes Surg2016;26:1422-8
|
| [92] |
Hussain A,El-Hasani S.The use of tranexamic acid in sleeve gastrectomy.Obes Surg2017;27:198-9
|
| [93] |
Klaassen RA,van den Berg JW,van der Harst E.Tranexamic acid therapy for postoperative bleeding after bariatric surgery.BMC Obes2018;5:36 PMCID:PMC6276262
|
| [94] |
Roberts I,Afolabi A.Effects of a high-dose 24-h infusion of tranexamic acid on death and thromboembolic events in patients with acute gastrointestinal bleeding (HALT-IT): an international randomised, double-blind, placebo-controlled trial.Lancet2020;395:1927-36 PMCID:PMC7306161
|
| [95] |
Karadaş A,Pinar SG.A randomized controlled trial of the effects of local tranexamic acid on mortality, rebleeding, and recurrent endoscopy need in patients with upper gastrointestinal hemorrhage.Eur J Gastroenterol Hepatol2020;32:26-31
|
| [96] |
Tavakoli N,Agah S.Comparison of the efficacy of intravenous tranexamic acid with and without topical administration versus placebo in urgent endoscopy rate for acute gastrointestinal bleeding: a double-blind randomized controlled trial.United European Gastroenterol J2018;6:46-54 PMCID:PMC5802678
|
| [97] |
Hawkey GM,McIntyre AS,Hawkey CJ.Drug treatments in upper gastrointestinal bleeding: value of endoscopic findings as surrogate end points.Gut2001;49:372-9 PMCID:PMC1728427
|
| [98] |
Holstein CC, Eriksson SB, Källén R. Tranexamic acid as an aid to reducing blood transfusion requirements in gastric and duodenal bleeding.Br Med J (Clin Res Ed)1987;294:7-10
|
| [99] |
Barer D,Henry D.Cimetidine and tranexamic acid in the treatment of acute upper-gastrointestinal-tract bleeding.N Engl J Med1983;308:1571-5
|
| [100] |
Bergqvist D,Hessman Y.Local inhibition of the fibrinolytic system in patients with massive upper gastrointestinal hemorrhage.Ups J Med Sci1980;85:173-8
|
| [101] |
Engqvist A,von Feilitzen F.Tranexamic acid in massive haemorrhage from the upper gastrointestinal tract: a double-blind study.Scand J Gastroenterol1979;14:839-44
|
| [102] |
Biggs JC,Dodds AJ.Tranexamic acid and upper gastrointestinal haemorrhage--a double-blind trial.Gut1976;17:729-34 PMCID:PMC1411285
|
| [103] |
Cormack F,Chakrabarti R.Tranexamic acid in upper gastrointestinal hæmorrhage.Lancet1973;301:1207-8
|
| [104] |
Gluud LL,Langholz E.Tranexamic acid for upper gastrointestinal bleeding.Cochrane Database Syst Rev2014;2014:CD006640 PMCID:PMC6599825
|
| [105] |
Kamal F,Lee-Smith W.Efficacy and safety of tranexamic acid in acute upper gastrointestinal bleeding: meta-analysis of randomised controlled trials.Scand J Gastroenterol2020;55:1390-7
|
| [106] |
Odutayo A,Trivella M.Restrictive versus liberal blood transfusion for gastrointestinal bleeding: a systematic review and meta-analysis of randomised controlled trials.2017;2:354-60
|
| [107] |
Rosenthal RJ,Kennedy CI,Zundel N.Laparoscopic surgery for morbid obesity: 1,001 consecutive bariatric operations performed at the bariatric institute, Cleveland Clinic Florida.Obes Surg2006;16:119-24
|
| [108] |
Chousleb E,Podkameni D.Routine abdominal drains after laparoscopic Roux-en-Y gastric bypass: a retrospective review of 593 patients.Obes Surg2004;14:1203-7
|
| [109] |
Scheirey CD,Shah PC.Radiology of the laparoscopic Roux-en-Y gastric bypass procedure: conceptualization and precise interpretation of results.Radiographics2006;26:1355-71
|
| [110] |
Simillis C,Bonanomi G.A challenging gastrointestinal hemorrhage after gastric bypass treated with interventional radiology.Surg Obes Relat Dis2016;12:e59-62
|
| [111] |
Mala T,Schou CF.Blood clot obstruction of the jejunojejunostomy after laparoscopic gastric bypass.Surg Obes Relat Dis2013;9:234-7
|
| [112] |
Awais O,Luketich JD.Acute, complete proximal small bowel obstruction after laparoscopic gastric bypass due to intraluminal blood clot formation.Surg Obes Relat Dis2005;1:418-22; discussion 422
|
| [113] |
Koppman JS,Gandsas A.Small bowel obstruction after laparoscopic Roux-en-Y gastric bypass: a review of 9,527 patients.J Am Coll Surg2008;206:571-84
|
| [114] |
Jossart GH.Complications of sleeve gastrectomy: bleeding and prevention.Surg Laparosc Endosc Percutan Tech2010;20:146-7
|
| [115] |
Choi YY,Hur KY,Kim YJ.Reinforcing the staple line during laparoscopic sleeve gastrectomy: does it have advantages?.Obes Surg2012;22:1206-13
|
| [116] |
Janik MR,Brągoszewski J,Paśnik K.Prediction model for hemorrhagic complications after laparoscopic sleeve gastrectomy: development of sleeve bleed calculator.Obes Surg2017;27:968-72 PMCID:PMC5339325
|
| [117] |
Sabry K,Habib H,Aboizeid .Management of acute bleeding post laparoscopic sleeve gastrectomy. Available from: https://www.omicsonline.org/open- [Last accessed on 12 Apr 2022]
|
| [118] |
da Rocha LC, Ayub Pérez OA, Arantes V. Endoscopic management of bariatric surgery complications: what the gastroenterologist should know.Rev Gastroenterol Mex2016;81:35-47
|
| [119] |
Richardson JF,Smith BR.Laparoscopic transgastric endoscopy after roux-en-y gastric bypass: case series and review of the literature.Am Surg2012;78:1182-6
|
| [120] |
BE-SAFE. Bariatric endoscopy- skill acquisition focused evaluation Available from: https://besafe.asmbs.org/ [Last accessed on 12 Apr 2022]
|
| [121] |
Guerrier JB,Schirmer BD.Reinforcement of the staple line during gastric sleeve: a comparison of buttressing or oversewing, versus no reinforcement- a single-institution study.Am Surg2018;84:690-4
|
| [122] |
Borjas G,Maldonado A,Ramos E.Oversewing staple line of the gastric remnant in gastric bypass reduces postoperative bleeding.Ann Med Surg (Lond)2021;67:102534 PMCID:PMC8267426
|
| [123] |
Abellán I,Lujan J.Stapling versus hand suture for gastroenteric anastomosis in Roux-en-Y gastric bypass: a randomized clinical trial.Obes Surg2015;25:1796-801
|
| [124] |
Fakas S,Lim D.Comparison of gastrojejunostomy techniques and anastomotic complications: a systematic literature review.Surg Endosc2021;35:6489-96
|
| [125] |
Rabl C,Prado K.Early and late abdominal bleeding after Roux-en-Y gastric bypass: sources and tailored therapeutic strategies.Obes Surg2011;21:413-20
|
| [126] |
Braley SC,Wolfe BM.Late gastrointestinal hemorrhage after gastric bypass.Obes Surg2002;12:404-7
|
| [127] |
Madan AK,Ternovits CA,Tichansky DS.Laparoscopic revision of the gastrojejunostomy for recurrent bleeding ulcers after past open revision gastric bypass.Obes Surg2006;16:1662-8
|
| [128] |
Antúnez DJ, Fernández NC, Serrano JO. Unusual case of upper gastrointestinal bleeding after laparoscopic gastric bypass: erosion of gastric remnant involving a diaphragmatic vessel.Surg Obes Relat Dis2011;7:328-9
|
| [129] |
Zerey M,Kuwada TS,Sing RF.Bleeding duodenal ulcer after roux-en-Y gastric bypass surgery.J Am Osteopath Assoc2008;108:25-7
|
| [130] |
Gupta A,Kalaskar SN.Late postoperative bleeding after Roux-en-Y gastric bypass: management and review of literature.BMJ Case Rep2018;11:e226271 PMCID:PMC6301526
|
| [131] |
Goel R,Goel M.Complications after bariatric surgery: a multicentric study of 11,568 patients from Indian bariatric surgery outcomes reporting group.J Minim Access Surg2021;17:213-20 PMCID:PMC8083745
|
| [132] |
Rasmussen JJ,Ali MR.Marginal ulceration after laparoscopic gastric bypass: an analysis of predisposing factors in 260 patients.Surg Endosc2007;21:1090-4
|
| [133] |
Maclean LD,Nohr C,Mclean AH.Stomal ulcer after gastric bypass11An editorial to this article can be found on page 87.J Am Coll Surg1997;185:1-7
|
| [134] |
Capella JF.Gastro-gastric fistulas and marginal ulcers in gastric bypass procedures for weight reduction.Obes Surg1999;9:22-7; discussion 28
|
| [135] |
Capella JF.Staple disruption and marginal ulceration in gastric bypass procedures for weight reduction.Obes Surg1996;6:44-9
|
| [136] |
Gill RS,Mohamed R.The role of upper gastrointestinal endoscopy in treating postoperative complications in bariatric surgery.J Interv Gastroenterol2012;2:37-41 PMCID:PMC3350909
|
| [137] |
Azagury DE,Greenwalt IT.Marginal ulceration after Roux-en-Y gastric bypass surgery: characteristics, risk factors, treatment, and outcomes.Endoscopy2011;43:950-4
|
| [138] |
Kitamura RK.The Management of GI bleeding after gastric bypass surgery.Int J Surg Res Pract2015;2:2. Available from: https://clinmedjournals.org/articles/ijsrp/international-journal
|
| [139] |
Puri V,Rubin M.Management of bleeding from gastric remnant after Roux-en-Y gastric bypass.Surg Obes Relat Dis2012;8:e3-5
|
| [140] |
Ross AS,Alverdy J,Dye C.Use of double-balloon enteroscopy to perform PEG in the excluded stomach after Roux-en-Y gastric bypass.Gastrointest Endosc2006;64:797-800
|
| [141] |
Silecchia G,Gentileschi P.Virtual gastroduodenoscopy: a new look at the bypassed stomach and duodenum after laparoscopic Roux-en-Y gastric bypass for morbid obesity.Obes Surg2002;12:39-48
|
| [142] |
Sakai P,Safatle-Ribeiro AV.Is it feasible to reach the bypassed stomach after Roux-en-Y gastric bypass for morbid obesity?.Endoscopy2005;37:566-9
|
| [143] |
Kuga R,Faintuch J.Endoscopic findings in the excluded stomach after Roux-en-Y gastric bypass surgery.Arch Surg2007;142:942-6
|
| [144] |
Coblijn UK,de Castro SM.The influence of prophylactic proton pump inhibitor treatment on the development of symptomatic marginal ulceration in Roux-en-Y gastric bypass patients: a historic cohort study.Surg Obes Relat Dis2016;12:246-52
|
| [145] |
Ying VW,Khan KJ.Prophylactic PPI help reduce marginal ulcers after gastric bypass surgery: a systematic review and meta-analysis of cohort studies.Surg Endosc2015;29:1018-23
|
| [146] |
Kang X,Hong D.A comparison of 30-day versus 90-day proton pump inhibitor therapy in prevention of marginal ulcers after laparoscopic Roux-en-Y gastric bypass.Surg Obes Relat Dis2016;12:1003-7
|