TY - JOUR
T1 - Unexplained abdominal pain in morbidly obese patients after bariatric surgery
AU - Pierik, Annouk S.
AU - Coblijn, Usha K.
AU - de Raaff, Christel A.L.
AU - van Veen, R. N.
AU - van Tets, Willem F.
AU - van Wagensveld, Bart A.
PY - 2017/10/1
Y1 - 2017/10/1
N2 - Background There is an overall complication rate of 6.3%–10% after bariatric surgery. After ruling out anatomic/physical causes, there is a substantial group of patients who develop unexplained postsurgical abdominal pain. Objectives To inventory the prevalence of unexplained abdominal pain after laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and to determine predictive factors for unexplained abdominal pain. Setting Obesity Center Amsterdam, Amsterdam, the Netherlands. Methods A retrospective study in a prospective database was performed. Baseline characteristics and postoperative course were evaluated. Results A total of 1788 patients underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy between November 2007 and April 2015. The average follow-up consisted of 33.5 months, without loss to follow-up. Abdominal pain was presented in 387 patients (21.6%). The study population consisted of 337 women (87.1%) and 50 men (12.9%); the mean age was 43.3 years (standard deviation 10.1) and the median preoperative body mass index was 43.7 kg/m². An explanation for abdominal pain was found in 246 of 387 patients (63.6%), whereas no explanation was found in 133 patients (34.4%). Revisional surgery was a significant predictor for unexplained pain (odds ratio 1.7; confidence interval 1.0–2.8; P = 0.037). Conclusion A total of 133 patients (7.4%) experienced unexplained abdominal pain after laparoscopic bariatric surgery. Revisional surgery was found to be a significant predictive factor for this outcome. Present study results suggest that postoperative unexplained abdominal pain is a significant morbidity and should be part of the informed consent. More research is needed regarding further diagnosis and management and treatment.
AB - Background There is an overall complication rate of 6.3%–10% after bariatric surgery. After ruling out anatomic/physical causes, there is a substantial group of patients who develop unexplained postsurgical abdominal pain. Objectives To inventory the prevalence of unexplained abdominal pain after laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and to determine predictive factors for unexplained abdominal pain. Setting Obesity Center Amsterdam, Amsterdam, the Netherlands. Methods A retrospective study in a prospective database was performed. Baseline characteristics and postoperative course were evaluated. Results A total of 1788 patients underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy between November 2007 and April 2015. The average follow-up consisted of 33.5 months, without loss to follow-up. Abdominal pain was presented in 387 patients (21.6%). The study population consisted of 337 women (87.1%) and 50 men (12.9%); the mean age was 43.3 years (standard deviation 10.1) and the median preoperative body mass index was 43.7 kg/m². An explanation for abdominal pain was found in 246 of 387 patients (63.6%), whereas no explanation was found in 133 patients (34.4%). Revisional surgery was a significant predictor for unexplained pain (odds ratio 1.7; confidence interval 1.0–2.8; P = 0.037). Conclusion A total of 133 patients (7.4%) experienced unexplained abdominal pain after laparoscopic bariatric surgery. Revisional surgery was found to be a significant predictive factor for this outcome. Present study results suggest that postoperative unexplained abdominal pain is a significant morbidity and should be part of the informed consent. More research is needed regarding further diagnosis and management and treatment.
KW - Bariatric surgery
KW - Postoperative complication
KW - Unexplained abdominal pain
UR - http://www.scopus.com/inward/record.url?scp=85024132421&partnerID=8YFLogxK
U2 - https://doi.org/10.1016/j.soard.2017.05.027
DO - https://doi.org/10.1016/j.soard.2017.05.027
M3 - Article
C2 - 28728833
SN - 1550-7289
VL - 13
SP - 1743
EP - 1751
JO - Surgery for Obesity and Related Diseases
JF - Surgery for Obesity and Related Diseases
IS - 10
ER -