Early and Late Abdominal Bleeding After Roux-en-Y Gastric Bypass: Sources and Tailored Therapeutic Strategies

• Published in: Obesity surgery 2011-04, Vol.21 (4), p.413-420
• Main Authors: Rabl, Charlotte, Peeva, Sofia, Prado, Kris, James, Aaron W., Rogers, Stanley J., Posselt, Andrew, Campos, Guilherme M.
• Format: Article
• Language: English
• Subjects: Adult; Blood Transfusion; Clinical Report; Female; Gastric Bypass; Gastrointestinal Hemorrhage - diagnosis; Gastrointestinal Hemorrhage - epidemiology; Gastrointestinal Hemorrhage - etiology; Gastrointestinal Hemorrhage - therapy; Gastrointestinal surgery; Hematocrit; Hemoperitoneum - diagnosis; Hemoperitoneum - epidemiology; Hemoperitoneum - etiology; Hemoperitoneum - therapy; Hemorrhage; Humans; Laparoscopy; Male; Medicine; Medicine & Public Health; Middle Aged; Obesity; Postoperative Hemorrhage - diagnosis; Postoperative Hemorrhage - epidemiology; Postoperative Hemorrhage - therapy; Reoperation; Retrospective Studies; Surgery; Time Factors
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1007/s11695-011-0354-9

Bleeding is a potentially serious complication after Roux-en-Y gastric bypass (RYGB). Preventive measures and therapeutic strategies have not been adequately defined. We reviewed data on 742 consecutive patients treated at the University of California San Francisco to identify cases of early and late bleeding (less or greater than 30 days after surgery) after RYGB. Bleeding was defined as symptoms or signs of bleeding, associated with blood transfusion. We recorded patient characteristics, details of the operative technique, diagnostic approach, therapeutic strategies, and outcomes. Twenty-six patients (3.5%) had postoperative bleeding, which mostly occurred in the first 30 days postoperatively ( N  = 19). Hematocrit decreased significantly from preoperative values (−5.2 ± 3.1 without bleeding vs. −14.8 ± 4.7 with, p