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Davrieux CF, Palermo M, Cúneo T, Zanutini D, Giménez ME. What is the Role of Image-Guided Endovascular Surgery in Postbariatric Surgery Bleeding Complications? J Laparoendosc Adv Surg Tech A 2020; 31:146-151. [PMID: 32936031 DOI: 10.1089/lap.2020.0696] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background: Obesity treatment requires surgical procedures included in bariatric surgery. Bleeding complications are reported in 1%-4%. Image-guided surgery (IGS) includes minimally invasive procedures that have the advantage of less aggression to the patient, fewer complications, and a quick recovery. Endovascular therapy by interventional radiology (IR) is a minimally invasive image-guided procedure widely used in central, peripheral, and splanchnic vascular pathology. Treatment of postoperative bleeding in bariatric surgery can be aided by image-guided endovascular procedures. Objectives: The aim of this study is to carry out an update on the application of IR in bariatric surgery bleeding complications. Bleeding Complications: General rate of postoperative complications in bariatric surgery is 0%-10%. Postoperative bleeding (1%-4%) can be gastrointestinal (endoscopic treatment) or intra-abdominal (surgical treatment/relaparoscopy). In the case of arterial vascular lesions that cannot be resolved either endoscopically or surgically, the option of endovascular treatment with IR should be considered. Conclusions: Endovascular approach through IR and IGS in bleeding complications after bariatric surgery is presented as a valid minimally invasive therapy option in this group of patients.
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Affiliation(s)
- Carlos Federico Davrieux
- DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.,Department of Surgery, Sanatorio de la Mujer, Rosario, Argentina
| | - Mariano Palermo
- DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.,Department of Bariatric Surgery, Diagnomed, Buenos Aires, Argentina.,School of Medicine, University of Buenos Aires, Buenos Aires, Argentina
| | - Tomás Cúneo
- Department of Interventional Radiology, Sanatorio Británico, Rosario, Argentina
| | - Daniel Zanutini
- Department of Interventional Radiology, Sanatorio Británico, Rosario, Argentina
| | - Mariano E Giménez
- DAICIM Foundation (Teaching, Research, Assistance in Minimal Invasive Surgery), Buenos Aires, Argentina.,School of Medicine, University of Buenos Aires, Buenos Aires, Argentina.,IRCAD (Institute for Research on Cancer of the Digestive System), Strasbourg, France.,IHU-Strasbourg (Hospital-University Institute), Strasbourg, France
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Docimo S, Svestka M. Endoscopic Evaluation and Treatment of Postoperative Bariatric Surgery Complications. Surg Innov 2017; 24:616-624. [PMID: 29072533 DOI: 10.1177/1553350617736651] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The number of patients undergoing bariatric surgery continues to increase. The American Society for Metabolic and Bariatric Surgery (ASMBS) estimates the number of bariatric surgical procedures performed increased from 158 000 in 2011 to 190 000 in 2015. Concurrently, the incidence of postoperative complications specific to bariatric patients will inevitably increase as well. Endoscopic evaluation of postoperative bariatric patients and endoscopic interventions are rapidly evolving. We present a review of the postoperative anatomy of bariatric patients, what complications to expect, and treatment options.
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