ORIGINAL ARTICLE  TECHNICAL CHALLENGE IN BARIATRIC SURGERY 

Minerva Surgery 2021 February;76(1):50-6

DOI: 10.23736/S2724-5691.20.08554-5

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Emergency Department visits after bariatric surgery

Emre GUNDOGDU ¹, Emir GULDOGAN ¹, Mahir OZMEN ^{1, 2} ✉

¹ Liv Hospital, Ankara, Turkey; ² Department of Surgery, School of Medicine, Istinye University, Istanbul, Turkey

BACKGROUND: Although bariatric surgery (BS) has an excellent safety profile, postoperative complications have undoubtedly increased due to the rise in the amount of operations performed annually. In parallel, the number of visits to the Emergency Department (ED) after surgery is increasing. The aim of this study was to describe the frequency, and the risk factors associated with postoperative ED visits after BS.
METHODS: This study included patients who had undergone different types of BS procedures between June 2016 and December 2019. Patients’ prior surgery types, ED visiting timings, main complaints, symptoms and the diagnoses they received, readmissions, and the interventions they had were noted and compared.
RESULTS: A total of 408 patients operated on using either the robotic or laparoscopic method due to morbid obesity, including 91 (22.3%) SG, 231 (56.6%) OAGB, 62 (15.2%) SADS-p, and 24 (5.8%) RS, were included into the study. During follow-up, fifty-three of the 408 patients applied to the Emergency Department 62 times with different complaints. ED admission rates in the OAGB group were significantly higher (P=0.04). While the most common complaint seen in the patients admitted to the ED after BS was localized abdominal pain with 25.8%, the most common diagnosis of the patients was cholelithiasis with a rate of 16.1%.
CONCLUSIONS: ED visits after BS usually continue intensively during the first year. Most of these applications can be prevented with regular outpatient follow-ups. Some of these require life-saving surgery in emergency conditions and do not allow the patient to be transferred to a bariatric center.

KEY WORDS: Bariatric surgery; Emergency service, hospital; Patient readmission; Obesity, morbid; Gastrectomy; Gastric bypass