Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass

Gautam Sharma, Jessica Ardila-Gatas, Mena Boules, Matthew Davis, James Villamere, John Rodriguez, Stacy A. Brethauer, Jeffrey Ponsky, Matthew Kroh

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Background Surgeons may be reluctant to perform upper gastrointestinal (UGI) endoscopy in the early post-operative period due to concern for anastomotic disruption. The aim of this study was to determine the safety and feasibility of early (≤ 30 days) post-operative UGI endoscopy after roux-en-y gastric bypass (RYGB). Methods A retrospective data analysis of a prospectively maintained database was completed between May 2002 and March 2015 for patients that had undergone UGI endoscopy within 30 days of their RYGB. Data analysis included baseline patient demographics, Charlson Comorbidity Index, perioperative parameters, indications for endoscopy; indications for any further endoscopic evaluation, interventions performed, and post-endoscopy complications. Results 190 patients underwent early postoperative UGI endoscopy after RYGB during the study period. Nineteen patients (10 %) had undergone revisional surgeries. The median duration to postoperative endoscopy was 22 days [IQR 16–26]. The most common indications included dysphagia (n = 74, 39%), abdominal pain (n = 53, 28%), nausea (n = 55, 29%), and vomiting (n = 47, 25%). Therapeutic interventions were performed in 79 patients (42%). These included balloon dilation (n = 66, 84%), feeding tube placement (n = 7, 9%), evacuation of clot (n = 2, 3%), epinephrine injection (n = 2, 3%) and coagulation of bleeding (n = 1, 1%). There were no post-UGI endoscopy anastomotic disruptions or leaks. Conclusion Endoscopy is helpful for the diagnosis and management of complications after RYGB. Despite the perceived risks, our study demonstrated no complications for both diagnostic and therapeutic endoscopy when performed in the early postoperative period.

Original languageEnglish (US)
Pages (from-to)885-891
Number of pages7
JournalSurgery (United States)
Volume160
Issue number4
DOIs
StatePublished - Oct 1 2016
Externally publishedYes

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Gastrointestinal Endoscopy
Gastric Bypass
Postoperative Period
Endoscopy
Enteral Nutrition
Deglutition Disorders
Nausea
Abdominal Pain
Epinephrine
Vomiting
Comorbidity
Dilatation
Demography
Databases
Hemorrhage
Safety
Injections
Therapeutics

All Science Journal Classification (ASJC) codes

  • Surgery

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Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass. / Sharma, Gautam; Ardila-Gatas, Jessica; Boules, Mena; Davis, Matthew; Villamere, James; Rodriguez, John; Brethauer, Stacy A.; Ponsky, Jeffrey; Kroh, Matthew.

In: Surgery (United States), Vol. 160, No. 4, 01.10.2016, p. 885-891.

Research output: Contribution to journalArticle

Sharma, G, Ardila-Gatas, J, Boules, M, Davis, M, Villamere, J, Rodriguez, J, Brethauer, SA, Ponsky, J & Kroh, M 2016, 'Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass', Surgery (United States), vol. 160, no. 4, pp. 885-891. https://doi.org/10.1016/j.surg.2016.07.001
Sharma, Gautam ; Ardila-Gatas, Jessica ; Boules, Mena ; Davis, Matthew ; Villamere, James ; Rodriguez, John ; Brethauer, Stacy A. ; Ponsky, Jeffrey ; Kroh, Matthew. / Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass. In: Surgery (United States). 2016 ; Vol. 160, No. 4. pp. 885-891.
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abstract = "Background Surgeons may be reluctant to perform upper gastrointestinal (UGI) endoscopy in the early post-operative period due to concern for anastomotic disruption. The aim of this study was to determine the safety and feasibility of early (≤ 30 days) post-operative UGI endoscopy after roux-en-y gastric bypass (RYGB). Methods A retrospective data analysis of a prospectively maintained database was completed between May 2002 and March 2015 for patients that had undergone UGI endoscopy within 30 days of their RYGB. Data analysis included baseline patient demographics, Charlson Comorbidity Index, perioperative parameters, indications for endoscopy; indications for any further endoscopic evaluation, interventions performed, and post-endoscopy complications. Results 190 patients underwent early postoperative UGI endoscopy after RYGB during the study period. Nineteen patients (10 {\%}) had undergone revisional surgeries. The median duration to postoperative endoscopy was 22 days [IQR 16–26]. The most common indications included dysphagia (n = 74, 39{\%}), abdominal pain (n = 53, 28{\%}), nausea (n = 55, 29{\%}), and vomiting (n = 47, 25{\%}). Therapeutic interventions were performed in 79 patients (42{\%}). These included balloon dilation (n = 66, 84{\%}), feeding tube placement (n = 7, 9{\%}), evacuation of clot (n = 2, 3{\%}), epinephrine injection (n = 2, 3{\%}) and coagulation of bleeding (n = 1, 1{\%}). There were no post-UGI endoscopy anastomotic disruptions or leaks. Conclusion Endoscopy is helpful for the diagnosis and management of complications after RYGB. Despite the perceived risks, our study demonstrated no complications for both diagnostic and therapeutic endoscopy when performed in the early postoperative period.",
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T1 - Upper gastrointestinal endoscopy is safe and feasible in the early postoperative period after Roux-en-Y gastric bypass

AU - Sharma, Gautam

AU - Ardila-Gatas, Jessica

AU - Boules, Mena

AU - Davis, Matthew

AU - Villamere, James

AU - Rodriguez, John

AU - Brethauer, Stacy A.

AU - Ponsky, Jeffrey

AU - Kroh, Matthew

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N2 - Background Surgeons may be reluctant to perform upper gastrointestinal (UGI) endoscopy in the early post-operative period due to concern for anastomotic disruption. The aim of this study was to determine the safety and feasibility of early (≤ 30 days) post-operative UGI endoscopy after roux-en-y gastric bypass (RYGB). Methods A retrospective data analysis of a prospectively maintained database was completed between May 2002 and March 2015 for patients that had undergone UGI endoscopy within 30 days of their RYGB. Data analysis included baseline patient demographics, Charlson Comorbidity Index, perioperative parameters, indications for endoscopy; indications for any further endoscopic evaluation, interventions performed, and post-endoscopy complications. Results 190 patients underwent early postoperative UGI endoscopy after RYGB during the study period. Nineteen patients (10 %) had undergone revisional surgeries. The median duration to postoperative endoscopy was 22 days [IQR 16–26]. The most common indications included dysphagia (n = 74, 39%), abdominal pain (n = 53, 28%), nausea (n = 55, 29%), and vomiting (n = 47, 25%). Therapeutic interventions were performed in 79 patients (42%). These included balloon dilation (n = 66, 84%), feeding tube placement (n = 7, 9%), evacuation of clot (n = 2, 3%), epinephrine injection (n = 2, 3%) and coagulation of bleeding (n = 1, 1%). There were no post-UGI endoscopy anastomotic disruptions or leaks. Conclusion Endoscopy is helpful for the diagnosis and management of complications after RYGB. Despite the perceived risks, our study demonstrated no complications for both diagnostic and therapeutic endoscopy when performed in the early postoperative period.

AB - Background Surgeons may be reluctant to perform upper gastrointestinal (UGI) endoscopy in the early post-operative period due to concern for anastomotic disruption. The aim of this study was to determine the safety and feasibility of early (≤ 30 days) post-operative UGI endoscopy after roux-en-y gastric bypass (RYGB). Methods A retrospective data analysis of a prospectively maintained database was completed between May 2002 and March 2015 for patients that had undergone UGI endoscopy within 30 days of their RYGB. Data analysis included baseline patient demographics, Charlson Comorbidity Index, perioperative parameters, indications for endoscopy; indications for any further endoscopic evaluation, interventions performed, and post-endoscopy complications. Results 190 patients underwent early postoperative UGI endoscopy after RYGB during the study period. Nineteen patients (10 %) had undergone revisional surgeries. The median duration to postoperative endoscopy was 22 days [IQR 16–26]. The most common indications included dysphagia (n = 74, 39%), abdominal pain (n = 53, 28%), nausea (n = 55, 29%), and vomiting (n = 47, 25%). Therapeutic interventions were performed in 79 patients (42%). These included balloon dilation (n = 66, 84%), feeding tube placement (n = 7, 9%), evacuation of clot (n = 2, 3%), epinephrine injection (n = 2, 3%) and coagulation of bleeding (n = 1, 1%). There were no post-UGI endoscopy anastomotic disruptions or leaks. Conclusion Endoscopy is helpful for the diagnosis and management of complications after RYGB. Despite the perceived risks, our study demonstrated no complications for both diagnostic and therapeutic endoscopy when performed in the early postoperative period.

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