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Management of Surgical Complications after Gastric Bypass 

Management of Surgical Complications after Gastric Bypass
Chapter:
Management of Surgical Complications after Gastric Bypass
Author(s):

Amin Andalib

, Zhamak Khorgami

, Tomasz G. Rogula

, and Philip R. Schauer

DOI:
10.1093/med/9780190608347.003.0028
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date: 09 December 2021

This chapter discusses the main issues with a selected group of surgical complications after Roux-en-Y gastric bypass. The main focus is on diagnosis and management of anastomotic leak and stricture, marginal ulcers, and gastrogastric fistulas. Anastomotic leak is one of the most feared and potentially catastrophic complications. The most common site is at gastrojejunostomy. Avoiding devascularization of the gastric pouch, creating a tension-free anastomosis, and performing an intraoperative anastomotic leak test are crucial technical points in preventing leaks. Once the leak is highly suspected or diagnosed, it needs to be managed swiftly. Different surgical techniques have different anastomotic stricture rates, with circular staplers being associated with the highest frequency of strictures at the gastrojejunostomy. Endoscopic dilatations are the mainstay of treatment.

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