Department of General Surgery, Ain Shams University.
Department of Surgery, Ain Shams University, Cairo, Egypt.
Surg Laparosc Endosc Percutan Tech. 2023 Dec 1;33(6):617-621. doi: 10.1097/SLE.0000000000001232.
One anastomosis gastric bypass (OAGB) has gained popularity among bariatric surgeons due to the shorter operative time, fewer sites for anastomotic leaks and internal herniation, shorter learning curve, ease of reversibility and revision with equivalent results to Roux en Y gastric bypass in terms of weight loss and co-morbidity resolution. We present our experience in managing early postoperative bleeding after OAGB.
Patients who underwent OAGB in Bariatric Surgery Unit, Ain Shams University Hospitals between January 2016 and January 2023 were followed up for 30 days for early postoperative complications. Patients were 210 females (70%) and 90 males, with a mean age of 41.3±7.1 years, and mean preoperative body mass index of 45.2±6.1 kg/m². The incidence of early postoperative bleeding, the sites of the bleeding and management strategy were reported.
Fourteen of 300 patients (4.67%) developed early postoperative bleeding after OAGB. Intraluminal bleeding occurred in 4 patients, 3 of which were controlled by endoscopy and one by laparoscopic suturing. Intra-abdominal bleeding occurred in 10 patients, 7 of which were successfully managed conservatively, and 3 required laparoscopic management. Two cases had both intra-abdominal bleeding and intraluminal bleeding in the distal stomach, confirmed by intraoperative endoscopy, and controlled by laparoscopic suturing.
Early postoperative bleeding after OAGB is a rare complication (4.67%). Conservative treatment is more successful in controlling intra-abdominal bleeding. In case of failed conservative treatment, laparoscopy is the method of choice. Most cases of intra-luminal bleeding need early endoscopic intervention.
由于手术时间更短、吻合口漏和内疝发生的部位更少、学习曲线更短、可逆转性更强以及与 Roux-en-Y 胃旁路术相比在减重和解决合并症方面具有同等效果，单吻合口胃旁路术 (OAGB) 在减重外科医生中越来越受欢迎。我们介绍了我们在处理 OAGB 术后早期出血方面的经验。
在 2016 年 1 月至 2023 年 1 月期间，在 Ain Shams 大学医院减重外科接受 OAGB 的患者在术后 30 天内接受了早期术后并发症的随访。患者包括 210 名女性（70%）和 90 名男性，平均年龄为 41.3±7.1 岁，平均术前体重指数为 45.2±6.1 kg/m²。报告了早期术后出血的发生率、出血部位和管理策略。
在 300 名患者中，有 14 名（4.67%）在 OAGB 后发生早期术后出血。4 名患者发生腔内出血，其中 3 名通过内镜治疗，1 名通过腹腔镜缝合治疗。10 名患者发生腹腔内出血，其中 7 名通过保守治疗成功治疗，3 名需要腹腔镜治疗。2 例患者在远端胃中既有腹腔内出血也有腔内出血，通过术中内镜证实，并通过腹腔镜缝合控制。
OAGB 术后早期出血是一种罕见的并发症（4.67%）。保守治疗更成功地控制腹腔内出血。如果保守治疗失败，腹腔镜是首选方法。大多数腔内出血病例需要早期内镜干预。
