SAN DIEGO — Nearly one-third of patients who underwent laparoscopic Roux-en-Y gastric bypass for morbid obesity were admitted to the emergency department, results from a 3-year, single-center study showed.
Abdominal pain and vomiting were the most common symptoms, Dr. Raul J. Rosenthal said at the annual meeting of the American Society for Bariatric Surgery.
Most patients who required emergency department (ED) admission (87%) were treated medically, but 12% required further surgery, said Dr. Rosenthal, a bariatric surgeon with Cleveland Clinic in Weston, Fla. It “is important to know that 12% of patients that come to the emergency room in the first year may end up in the operating room,” he said.
He and his associates studied the medical records of 733 people who underwent laparoscopic Roux-en-Y gastric bypass for morbid obesity between 2001 and 2004. The mean age of patients was 45 years, and their mean body mass index was 50 kg/m
Of the 733 patients studied over the 3-year period at the Cleveland Clinic in Weston, 228 (31%) had a history of ED admission. Patients who experienced postoperative complications within 6 days of surgery had a higher rate of ED admissions than did those who experienced postoperative complications on or after 7 days (61% vs. 30%, respectively).
Operation time was significantly longer for patients in the ED admission group (a mean of 91 minutes vs. 87 minutes among those who did not require admission to the emergency department).
Abdominal pain was the most common presenting symptom, followed by vomiting and both nausea and vomiting.
The most common diagnosis was dehydration, followed by obstruction of an anastomosis and stomal ulcer.
Dr. Rosenthal noted that 82% of the emergency department admissions occurred in postoperative year 1. Of these patients, 25% were admitted to the hospital and 12% required surgical treatment.
Of the 733 patients studied over the 3-year period, 228 (31%) had a history of ED admission. DR. ROSENTHAL