TY  - JOUR
T1  - ROux-en-y gastric bypass leak complications
AU  - Marshall J, Srivastava A, Gupta SK, Rossi TR, DeBord JR
Y1  - 2003/05/01
N1  - 10.1001/archsurg.138.5.520
JO  - Archives of Surgery
SP  - 520
EP  - 524
VL  - 138
IS  - 5
N2  - Hypothesis 
    Enteric leakage is a significant complication of the Roux-en-Y gastric bypass (RYGB) procedure that can be treated successfully.Design 
    Retrospective study of 400 consecutive RYGB patients from 1999-2002.Setting 
    Community hospital with a university surgical residency.Patients 
    Hospital records of 400 morbidly obese patients who underwent gastric bypass surgery were reviewed.Main Outcome Measures 
    Time of discovery of leak, location of leak, treatment, hospital stay, and mortality.Results 
    Twenty-one patients (5.25%) developed leaks. The mean body mass index (calculated as weight in kilograms divided by the square of height in meters) was 54.2. Thirteen patients were noted to develop a leak at the gastrojejunal anastomosis, with an average time to diagnosis of 7.0 days. Five of these patients underwent reexploration, and 8 were successfully treated with percutaneous drainage alone. Four patients developed leaks at the jejunojejunal anastomosis (mean time to diagnosis, 2.0 days). All of these patients required exploration, and 2 patients died. Four patients were noted to have leaks in other areas (average time to diagnosis, 3.5 days). Two patients were treated with drainage, and 2 underwent exploration. The average hospital stay of all patients was 33 days.Conclusions 
    Enteric leakage is a significant complication of the RYGB. Patients who are suspected of having an enteric leak because of signs of sepsis or hemodynamic instability require emergent exploration. Leaks that are more insidious may be treated successfully with percutaneous drainage. Aggressive exploration of patients who appear to be septic, and percutaneous drainage of insidiously developing leaks may decrease patients' morbidity and mortality.
SN  - 0004-0010
M3  - doi: 10.1001/archsurg.138.5.520
UR  - http://dx.doi.org/10.1001/archsurg.138.5.520
ER  -