1. Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines
- Author
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Belinda De Simone, Elie Chouillard, Almino C. Ramos, Gianfranco Donatelli, Tadeja Pintar, Rahul Gupta, Federica Renzi, Kamal Mahawar, Brijesh Madhok, Stefano Maccatrozzo, Fikri M. Abu-Zidan, Ernest E. Moore, Dieter G. Weber, Federico Coccolini, Salomone Di Saverio, Andrew Kirkpatrick, Vishal G. Shelat, Francesco Amico, Emmanouil Pikoulis, Marco Ceresoli, Joseph M. Galante, Imtiaz Wani, Nicola De’ Angelis, Andreas Hecker, Gabriele Sganga, Edward Tan, Zsolt J. Balogh, Miklosh Bala, Raul Coimbra, Dimitrios Damaskos, Luca Ansaloni, Massimo Sartelli, Nikolaos Pararas, Yoram Kluger, Elias Chahine, Vanni Agnoletti, Gustavo Fraga, Walter L. Biffl, Fausto Catena, De Simone, B, Chouillard, E, Ramos, A, Donatelli, G, Pintar, T, Gupta, R, Renzi, F, Mahawar, K, Madhok, B, Maccatrozzo, S, Abu-Zidan, F, E. Moore, E, Weber, D, Coccolini, F, Di Saverio, S, Kirkpatrick, A, Shelat, V, Amico, F, Pikoulis, E, Ceresoli, M, Galante, J, Wani, I, De' Angelis, N, Hecker, A, Sganga, G, Tan, E, Balogh, Z, Bala, M, Coimbra, R, Damaskos, D, Ansaloni, L, Sartelli, M, Parasas, N, Kluger, Y, Chahine, E, Agnoletti, V, Fraga, G, Biffl, W, Catena, F, De Simone B., Chouillard E., Ramos A.C., Donatelli G., Pintar T., Gupta R., Renzi F., Mahawar K., Madhok B., Maccatrozzo S., Abu-Zidan F.M., E. Moore E., Weber D.G., Coccolini F., Di Saverio S., Kirkpatrick A., Shelat V.G., Amico F., Pikoulis E., Ceresoli M., Galante J.M., Wani I., De' Angelis N., Hecker A., Sganga G., Tan E., Balogh Z.J., Bala M., Coimbra R., Damaskos D., Ansaloni L., Sartelli M., Parasas N., Kluger Y., Chahine E., Agnoletti V., Fraga G., Biffl W.L., Catena F., De Simone, Belinda, Chouillard, Elie, Ramos, Almino C., Donatelli, Gianfranco, Pintar, Tadeja, Gupta, Rahul, Renzi, Federica, Mahawar, Kamal, Madhok, Brijesh, Maccatrozzo, Stefano, Abu-Zidan, Fikri M., E. Moore, Ernest, Weber, Dieter G., Coccolini, Federico, Di Saverio, Salomone, Kirkpatrick, Andrew, Shelat, Vishal G., Amico, Francesco, Pikoulis, Emmanouil, Ceresoli, Marco, Galante, Joseph M., Wani, Imtiaz, De’ Angelis, Nicola, Hecker, Andrea, Sganga, Gabriele, Tan, Edward, Balogh, Zsolt J., Bala, Miklosh, Coimbra, Raul, Damaskos, Dimitrio, Ansaloni, Luca, Sartelli, Massimo, Parasas, Nikolao, Kluger, Yoram, Chahine, Elia, Agnoletti, Vanni, Fraga, Gustavo, Biffl, Walter L., and Catena, Fausto
- Subjects
Sleeve gastrectomy ,Abdomen, Acute ,Bariatric surgery ,Abdominal pain ,Perforation ,Occlusion ,Peritoniti ,Bleeding ,Obesity, Morbid ,Acute abdomen ,Meta-Analysis as Topic ,Gastric bypa ,Long-term complication ,Weight Loss ,Emergency surgery ,Emergency Medicine ,Humans ,Surgery ,Systematic Reviews as Topic - Abstract
Background Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Method A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. Conclusions The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.
- Published
- 2022