The study followed patients at the University Hospitals of Cleveland after Roux-en-Y gastric bypass surgery, the most popular surgical procedure to aid weight loss in severely obese patients. The surgery involves stapling the upper stomach to create a small pouch that is then attached to the small intestine, thereby reducing stomach capacity and the intestine's ability to absorb nutrients.
Among the 335 patients that participated in the study, radiological imaging revealed 57 complications from the surgeries -- many of them multiple problems in the same patients -- including suture tears and leaks, pulmonary embolism, pneumonia and infection.
"Severely obese patients are at high risk for any type of surgery because of other conditions related to their weight," said Duke radiologist Elmar Merkle, M.D., formerly of the University Hospitals of Cleveland where the study was conducted. "In addition, there is a wide spectrum of procedure-specific complications following Roux-en-Y gastric bypass."
Merkle presented the findings today (Dec. 1, 2003) at the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America.
The results emphasize that the procedure should be a last resort after all other interventions, such as diet and exercise, have been attempted, said Merkle. The findings also highlight the importance of radiological imaging in diagnosing surgical complications in severely obese patients following gastric bypass, he added.
The researchers reported eight cases of leaks from the stomach into the surrounding abdominal cavity and five instances of staple line disruption in the stomach, complications specific to Roux-en-Y. The
Contact: Kendall Morgan
Duke University Medical Center