It is not uncommon for morbid obese patients who undergo gastric bypass surgery to have complications, says Jinxing Yu, MD, of the Medical College of Virginia Hospital in Richmond. Leaks, abscesses, dilated excluded stomach, small bowel obstruction, and hernias are a few of the complications that can occur, he says.
From March 1998 to July 2002, 890 patients underwent gastric bypass surgery at the Medical College of Virginia Hospital. “Among them, 35 image-guided procedures were performed in 28 patients. Using CT, fluoroscopy, or ultrasound guidance, needles or catheters were placed into the fluid or air-fluid collections which were associated with leaks, abscesses, or seroma, or into the distended excluded stomach which required decompression,” says Dr. Yu. Four of the patients had more than one interventional procedure, he says. All of the patient’s symptoms were much relieved by these procedures, he says.
Four of the patients in this group did require additional surgery to correct underlying problems—two with small bowel obstruction, one with recurrent fluid filled and dilated fundus, and one with a leak. The interventional procedures helped ease these patients’ symptoms and allowed time for optimization of the patients prior to the second surgery, Dr. Yu adds.
These patients are part of a high-risk population, notes Dr. Yu. The interventional procedures are less invasive and better tolerated than repeat surgery. Each procedure takes about an hour, he says. The hospital stays after interventional procedures are much shorter than what they are for surgery, Dr. Yu notes.
“The morbid obesity of the patients in the study created a unique challenge and did require some alterations in technique,” says Dr. Yu. “However, a good understanding of complications following gastric bypass surgery plus careful planning did yield a high success rate,” Dr. Yu says.
Dr. Yu will present the study May 7 at the American Roentgen Ray Society Annual Meeting in San Diego.
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