Conference Proceeding - Restricted Access
Surgery for Obesity and Related Diseases
Early postoperative bleeding is an uncommon complication after Roux-en-Y gastric bypass, and is often self-limited, but can cause significant morbidity when uncontrolled hemorrhage occurs. Factors correlating with severe hemorrhage versus self-limited bleeding are unknown.
A retrospective review was performed using prospectively collected data for all patients undergoing Roux-en-Y gastric bypass surgery over 5.5 years at our institution. Patients were grouped based on post-operative bleeding: no bleeding (/dL hemoglobin drop), self-limited (> 2 g/dL hemoglobin drop, without transfusion or intervention), and hemorrhage (requiring transfusion or intervention). The ‘self-limited’ and ‘hemorrhage’ groups were compared. Categorical data were analyzed using
Of 430 patients, 360 (83.7%) had no bleeding, 43 (10%) had self-limited bleeding, and 27 (6.3%) had hemorrhage. Hemorrhage patients were more likely to have preoperative liver disease compared to ‘self-limited’ bleeding patients 18.5% vs. 2.3% (p=0.029). Following surgery, hemorrhage patients had more frequent ileus 11.1% vs. 0% (p=0.026), extended LOS 40.7% vs. 18.6% (p=0.043), postop ED visits 44.4% vs. 14.0% (p=0.004), readmissions 44.4% vs. 4.6% (p
Uncontrolled bleeding after Roux-en-Y gastric bypass leads to significantly worse outcomes compared to patients who have a self-limited hemoglobin decrease. Patients with preoperative liver disease are at higher risk of post-operative hemorrhage; other factors influencing the development of hemorrhage vs. self-limited bleeding remain unclear...
Odil E, Reilly J, Studzinski D, Zeigler K. Postoperative hemorrhage versus self-limited bleeding after Roux-en-Y gastric bypass: what are the risk factors? Surg Obes Relat Dis. 2022 Jul;18(8 Suppl):S35-S36. doi:10.1016/j.soard.2022.06.124.