1. Clinical symptoms are correlated with gastrojejunal anastomosis complications only during the first year after laparoscopic Roux-en-Y gastric bypass
- Author
-
Vicente Sanchiz Soler, María Lapeña Rodríguez, Jose Martín Arévalo, Joaquín Ortega Serrano, Raquel Alfonso Ballester, and Norberto Cassinello Fernández
- Subjects
Adult ,Male ,medicine.medical_specialty ,Time Factors ,Medicine (miscellaneous) ,Laparoscopic Roux-en-Y gastric bypass ,Epigastric pain ,Cohort Studies ,Postoperative Complications ,medicine ,Upper gastrointestinal endoscopy ,Humans ,Pathological ,Retrospective Studies ,Nutrition and Dietetics ,medicine.diagnostic_test ,business.industry ,Retrospective cohort study ,Anastomosis, Roux-en-Y ,Gastrojejunal complication ,Middle Aged ,medicine.disease ,Roux-en-Y anastomosis ,Surgery ,Endoscopy ,Abdominal Pain ,Food intolerance ,Presentation (obstetrics) ,business ,Complication - Abstract
Introduction: Introduction: after laparoscopic Roux-en-Y gastric bypass (LRYGBP) many patients complain of epigastric pain or food intolerance, leading to the performance of upper gastrointestinal (UGI) endoscopy. Objective: this study aims to assess which symptomatology as reported by LRYGBP patients during follow-up suggested correlation with pathological findings of endoscopy, and which factors might play a role, taking the timing of symptom presentation into account. Materials and methods: a retrospective cohort study was performed identifying LRYGBP patients presenting with food intolerance and/or epigastric pain who had undergone endoscopy. Primary outcomes were endoscopy findings, their association with patient characteristics, and timing of symptom presentation. Results: of the 514 patients complaining of epigastric pain and/or food intolerance, 81 (15.6 %) underwent endoscopy. A gastrojejunostomy complication was found in 58 % of cases. All patients who complained about food intolerance and epigastric pain presented pathological findings. The only preoperative factor associated with a gastrojejunostomy complication was being a smoker (p = 0.021). Time between surgery and endoscopy was also a predictive factor for endoscopic pathological findings (p = 0.007); in cases of epigastric pain, symptom onset during the first year (median: 10 months) was related to increased risk of gastrojejunal complications (p < 0.05). Conclusions: endoscopies performed within one year of surgery were significantly more likely to reveal pathological findings than endoscopies performed after the first postoperative year, especially in patients experiencing epigastric pain. Introduccion: Introduccion: tras un baipas gastrico laparoscopico en Y de Roux muchos pacientes refieren dolor epigastrico o intolerancia alimenticia, lo que motiva la realizacion de una endoscopia digestiva alta. Objetivos: el objetivo de este estudio es intentar establecer una relacion entre la sintomatologia referida por los pacientes sometidos a baipas gastrico con los hallazgos endoscopicos patologicos y conocer que factores pueden estar implicados, considerando el momento de presentacion. Material y metodos: estudio retrospectivo de cohortes, identificando a los pacientes sometidos a baipas gastrico laparoscopico que presentan dolor epigastrico o intolerancia alimenticia durante el seguimiento y a los que se realizo una endoscopia digestiva alta. El objetivo primario es relacionar los hallazgos endoscopicos con la sintomatologia y el momento de aparicion. Resultados: de los 514 pacientes que presentaban dolor epigastrico o intolerancia alimenticia, 81 (15,6 %) fueron sometidos a endoscopia digestiva alta. En un 58 % de los casos se encontraron complicaciones relacionadas con la gastroyeyunostomia. En todos los pacientes que presentaban simultaneamente dolor e intolerancia aparecieron hallazgos endoscopicos patologicos. El unico factor preoperatorio relacionado con las complicaciones fue el habito tabaquico (p = 0,021). El tiempo entre la cirugia y la realizacion de la endoscopia tambien fue un factor significativamente relacionado con los hallazgos endoscopicos (p = 0,007). En los casos de dolor epigastrico durante el primer ano (media: 10 meses) existia un incremento del riesgo de aparicion de complicaciones de la gastroyeyunostomia (p < 0,05). Conclusiones: las endoscopias realizadas durante el primer ano postoperatorio tenian mas probabilidades de presentar hallazgos patologicos, sobre todo en los pacientes afectos de dolor epigastrico.
- Published
- 2021