XXXX after gastric bypass: a new and simplified technique for laparoscopic primary closure of the mesenteric defects.

@entity1 @entity63 @entity490 @entity547 @entity1744 @entity356
BACKGROUND: @entity1744 due to @entity547 is a well-known complication of @entity356 ( @entity356 ). Increasing evidence supports primary closing of the mesenteric defects, but controversy continues about surgical technique of systematic closure. This paper reviews our experience with @entity547 after @entity356 and describes a new method of preemptive closure of the mesenteric defects. MATERIAL AND METHODS: Two thousand four hundred seventy-two consecutive @entity1 undergoing @entity356 from September 2005 to June 2010 were entered into our prospective longitudinal database. The mesenteric defects were not closed. @entity1 entered a 5-year follow-up program, and all who subsequently presented with @entity547 were analyzed. A further 1,630 @entity1 operated on in the last 12 months were subjected to our new technique of closing the defects; data were entered in our own database as well as in the Scandinavian quality registry. Follow-up time for these @entity1 is limited. RESULTS: In the first group, 117 @entity1 developed an @entity547 (4.7%) at a mean interval after @entity356 of 13 (range, 4-43 months). Four @entity1 needed bowel resections because of severe @entity63 . There was one death associated with complication of the @entity547 . In the primary closure group, four @entity1 early in the series had reoperations for kinking of the enteroanastomosis. There have been no mesenteric haematomas encountered. CONCLUSIONS: @entity547 should be ruled out in @entity1 with previous @entity356 and @entity490 . Our technique for primary closing of the mesenteric defects seems to be safe and is so far promising.
