Endoscopic management of early upper XXXX following laparoscopic Roux-en-Y gastric bypass.

@entity1 @entity548 @entity75 @entity1425 @entity86 @entity360 @entity1173
BACKGROUND AND AIMS: @entity360 ( @entity360 ) is an infrequent complication (1-3.8%) following laparoscopic Roux-en-Y gastric bypass (LRYGB). The safety and efficacy of endoscopic management of immediate @entity86 is unknown. We sought to determine how frequently @entity360 complicates LRYGB and whether endoscopic management is successful in controlling @entity548 . METHODS: Retrospective chart review of all @entity1 who developed @entity360 following LRYGB from November 2001 to July 2005 at a large suburban teaching hospital. RESULTS: Of 933 @entity1 who underwent LRYGB, 30 (3.2%) developed postoperative @entity360 . An endoscopic esophagogastroduodenoscopy (EGD) was performed in 27/30 @entity1 (90%). All were found to have @entity548 emanating from the gastrojejunostomy (GJ) staple line. Endoscopic intervention was performed in 24/30 (80%) with @entity1425 injection and heater probe cautery being used most commonly. Endoscopic therapy was ultimately successful in controlling all @entity548 , with 5 @entity1 (17%) requiring a second EGD for rebleeding. No @entity1 required surgery to control @entity548 . One @entity1 aspirated during the endoscopic procedure with subsequent anoxic @entity75 and died 5 days postoperatively. Twenty-one @entity1 (70%) developed @entity360 in the intraoperative or immediate postoperative period (<4 h postoperative). The mean length of stay was significantly longer in these @entity1 (2.84 vs 4.1, P= 0.001). CONCLUSIONS: (a) @entity360 complicates LRYGB in a small but significant number of @entity1 . (b) Bleeding usually occurs at the GJ site. (c) EGD is safe and effective in controlling @entity548 with standard endoscopic techniques. (d) @entity360 occurs most commonly in the immediate postoperative period and may be best managed in the operating room with the @entity1 intubated to prevent @entity1173 .
