Clinical predictors of leak after laparoscopic Roux-en-Y gastric bypass for morbid obesity

E. C. Hamilton, T. L. Sims, T. T. Hamilton, M. A. Mullican, D. B. Jones, D. A. Provost

Research output: Contribution to journalArticle

140 Scopus citations

Abstract

Background: Gastrointestinal leak is a complication of laparoscopic Roux-en-Y gastric bypass (LRYGB). Contrast studies may underdiagnose leaks, forcing surgeons to rely solely on clinical data. This study was designed to evaluate various clinical signs for detecting leakage after LRYGB. Methods: We retrospectively reviewed 210 consecutive patients who underwent LRYGB between April 1999 and September 2001. There were nine documented leaks (4.3%). Clinical signs between patients with leaks (group 1) and those without leaks (group 2) were compared using univariate and multivariate logistic regression analysis. Results: Evidence of respiratory distress and a heart rate exceeding 120 beats per min were the two most sensitive indicators of gastrointestinal leak. Routine upper gastrointestinal contrast imaging detected only two of nine leaks (22%). Conclusion: Leak after LRYGB may be difficult to detect. Evidence of respiratory distress and tachycardia exceeding 120 beats per min may be the most useful clinical indicators of leak after laparoscopic Roux-en-Y gastric bypass.

Original languageEnglish (US)
Pages (from-to)679-684
Number of pages6
JournalSurgical Endoscopy and Other Interventional Techniques
Volume17
Issue number5
DOIs
StatePublished - May 1 2003

Keywords

  • Clinical predictors
  • Contrast study
  • Gastrointestinal leak
  • Laparoscopic Roux-en-Y gastric bypass
  • Morbid obesity

ASJC Scopus subject areas

  • Surgery

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