Clinic of Medicine and Rehabilitation, More and Romsdal Hospital Trust, Alesund, Norway.
Center for Obesity, Department of Surgery, St. Olav Hospital, Trondheim University Hospital, Trondheim, Norway.
Obes Surg. 2018 Sep;28(9):2609-2616. doi: 10.1007/s11695-018-3223-y.
Acute, intermittent, and chronic abdominal pain is a common complaint after Roux-en-Y gastric bypass (RYGB).
The aim of the study was to evaluate the use of medical imaging and the need for surgery treating abdominal pain after RYGB in a cohort with long-term follow-up.
Data from 569 patients who underwent RYGB as the primary bariatric procedure at a public hospital in Norway between April 2004 and June 2011 were prospectively registered in a local quality registry for bariatric surgery. All abdominal imaging and abdominal surgical procedures were registered until August 2017.
Mean follow-up was 100 months (61-159). During the observation period, 22% had one CT, 9% had two CTs, 4% had three CTs, and 5% had four or more CTs for abdominal pain. Twenty-two percent underwent abdominal surgery, as 16% had one and 6% had two or more operations and gynecological procedures excluded. The purpose of operation was postoperative complications (1.4%), suspected internal herniation (9.3%), cholecystectomy (9.3%), appendectomy (2.3%), hernias (3.2%), and perforated ulcer in the gastrojejunal anastomosis (0.7%). Mean time interval was 42 ± 27 months from RYGB to cholecystectomy and 51 ± 26 months for suspected IH.
With a mean follow-up period of more than 8 years after RYGB, 40% of the patients suffered from abdominal pain, needing one or more CT scans. The need for surgery treating suspected internal hernia and cholecystectomy was equal, at 9.3% for both procedures, but the mean time from RYGB to operation was shorter for cholecystectomies.
在 Roux-en-Y 胃旁路术（RYGB）后，急性、间歇性和慢性腹痛是一种常见的主诉。
本研究旨在评估在长期随访的患者队列中，使用医学影像学检查和手术治疗 RYGB 后腹痛的情况。
2004 年 4 月至 2011 年 6 月期间，挪威一家公立医院对 569 例患者行 RYGB 作为主要减肥手术，前瞻性地在当地减肥手术质量登记处进行登记。所有腹部影像学检查和腹部手术均在 2017 年 8 月前进行登记。
平均随访时间为 100 个月（61-159）。在观察期间，22%的患者进行了一次 CT 检查，9%的患者进行了两次 CT 检查，4%的患者进行了三次 CT 检查，5%的患者进行了四次或更多次 CT 检查以诊断腹痛。22%的患者接受了腹部手术，其中 16%的患者进行了一次手术，6%的患者进行了两次或更多次手术，不包括妇科手术。手术的目的是治疗术后并发症（1.4%）、疑似内疝（9.3%）、胆囊切除术（9.3%）、阑尾切除术（2.3%）、疝（3.2%）和胃肠吻合口穿孔性溃疡（0.7%）。从 RYGB 到胆囊切除术的平均时间间隔为 42±27 个月，疑似 IH 的平均时间间隔为 51±26 个月。
在 RYGB 后平均随访 8 年以上的时间里，40%的患者出现腹痛，需要进行一次或多次 CT 扫描。疑似内疝和胆囊切除术的手术需求相同，均为 9.3%，但胆囊切除术的平均手术时间更短。
