Endoscopic hemostasis using endoclip in early gastrointestinal hemorrhage after gastric bypass surgery

Shou Jiang Tang, Homero Rivas, Linda Tang, Luis F. Lara, Jayaprakash Sreenarasimhaiah, Don C. Rockey

Research output: Contribution to journalArticle

26 Scopus citations

Abstract

Roux-en-Y gastric bypass (RYGBP) is the most commonly performed bariatric operation in the USA. In the early postoperative stage, gastrointestinal (GI) bleeding is an infrequent but potentially serious complication that usually results from bleeding at the gastrojejunostomy staple-line. Observant management with transfusion for stable patients and surgical exploration for unstable patients is typically recommended for early GI bleeding. We hypothesized that use of endoclips, which do not cause thermal injury to the surrounding tissues (or anastomosis), may be preferable to thermal approaches which could cause tissue injury. We report 2 cases of early GI bleeding after RYGBP that were successfully managed with endoclip application to bleeding lesions. Emergent endoscopy was performed, and major stigmata such as active spurting vessel and adherent clot were noted at the gastrojejunostomy staple-lines. Endoscopic hemostasis using endoclips was readily applied to bleeding lesions at staple-lines. Primary hemostasis was achieved, and there was no recurrent bleeding or complication. We conclude that therapeutic endoscopy can be performed safely for early bleeding after RYGBP. In patients with early bleeding after RYGBP, use of endoclips is mechanistically preferable to other options.

Original languageEnglish (US)
Pages (from-to)1261-1267
Number of pages7
JournalObesity Surgery
Volume17
Issue number9
DOIs
StatePublished - Sep 1 2007

Keywords

  • Bariatric surgery
  • Endoclip hemostasis
  • Hemorrhage
  • Morbid obesity
  • Postoperative complications
  • Roux-en-Y gastric bypass

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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