Fernández-Esparrach Gloria, Córdova Henry, Bordas Josep M, Gómez-Molins Inés, Ginès Angels, Pellisé Maria, Sendino Oriol, González-Suárez Begoña, Cárdenas Andres, Balderramo Domingo, Lacy Antonio M, Delgado Salvadora, Llach Josep
Unidad de Endoscopia, Servicio de Gastroenterología, ICMDiM, Hospital Clínic, Universidad de Barcelona, IDIBAPS, CIBEREHD, España.
Gastroenterol Hepatol. 2011 Mar;34(3):131-6. doi: 10.1016/j.gastrohep.2010.12.003. Epub 2011 Mar 5.
Many patients who undergo bariatric surgery develop postoperative gastrointestinal complications that can require upper gastrointestinal endoscopy.
To prospectively describe the gastrointestinal complications diagnosed by endoscopy after bariatric surgery.
We followed up patients undergoing laparoscopic bariatric surgery between January 1998 and December 2006. The following data were recorded: age, sex, body mass index, comorbidity, type and duration of bariatric surgery, clinical presentation of complications, time of presentation, endoscopic treatment and follow-up.
A total of 474 patients underwent surgery (74% women, 26% men) with a mean age of 44±11 years (range, 15-66) and a mean BMI of 47±7 (range, 33-82). The most frequent surgical procedure was Roux-en-Y gastric bypass (90%). We identified 68 complications (14%) requiring upper gastrointestinal endoscopy: anastomotic stenosis (21 cases, 5%), upper gastrointestinal hemorrhage (16 cases, 3.6%), epigastric pain (12 cases, 2.5%), vomiting (7 cases, 1.5%), heartburn (6 cases, 1.3%) and other (6 cases, 1.3%). No prognostic factor for the development of complications requiring postsurgical endoscopy was identified.
Anastomotic stenosis is the most common complication requiring endoscopic treatment after bariatric surgery. Upper gastrointestinal bleeding in the immediate and late postoperative period can be safely and effectively treated with endoscopic techniques.
许多接受减肥手术的患者会出现术后胃肠道并发症，可能需要进行上消化道内镜检查。
前瞻性描述减肥手术后经内镜诊断的胃肠道并发症。
我们对1998年1月至2006年12月期间接受腹腔镜减肥手术的患者进行了随访。记录了以下数据：年龄、性别、体重指数、合并症、减肥手术的类型和持续时间、并发症的临床表现、出现时间、内镜治疗及随访情况。
共有474例患者接受了手术（74%为女性，26%为男性），平均年龄为44±11岁（范围15 - 66岁），平均体重指数为47±7（范围33 - 82）。最常见的手术方式是Roux-en-Y胃旁路术（90%）。我们确定了68例需要进行上消化道内镜检查的并发症（14%）：吻合口狭窄（21例，5%）、上消化道出血（16例，3.6%）、上腹部疼痛（12例，2.5%）、呕吐（7例，1.5%）、烧心（6例，1.3%）及其他（6例，1.3%）。未发现术后需要内镜检查的并发症发生的预后因素。
吻合口狭窄是减肥手术后需要内镜治疗的最常见并发症。术后早期和晚期的上消化道出血可通过内镜技术安全有效地治疗。
