Safe intestinal decompression in fresh postoperative gastric bypass.

Safe intestinal decompression in fresh postoperative gastric bypass. Research Abstract Details 

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Safe intestinal decompression in fresh postoperative gastric bypass. Abstract Text:

Carlos Carrasquilla,Michael Weiss,Jennifer Gianos,

BACKGROUND: Dilatation of the Roux-limb is sometimes found following Roux-en-Y gastric bypass (RYGBP) procedures. This could be the result of a transient episode due to ileus, or a partial or complete obstruction. The risk of this complication is an increase in intraluminal pressure with the potential for leak. Blind insertion of a nasogastric tube for decompression could be risky due to possible perforation at the stapled or sutured edges. METHODS AND RESULTS: The diagnosis was made with routine extended upper gastrointestinal x-rays 24 hours after surgery. To determine the relationship of the intestinal dilatation, increase in intraluminal pressures and leaks, measurements were taken in porcine models duplicating a RYGBP. Pressures obtained at the anastomoses were higher than pressures in the jejunum between the anastomoses, and related directly to the production of leaks. Elevations of intraluminal intestinal pressures have also been observed in patients who required decompression. The angles of a freshly constructed pouch and the recent stapled or sutured edges may be easily perforated with a nasogastric tube, especially a hard one. We use a soft flexible tube. An angled-end 0.035" wire is introduced into the intestines with fluoroscopic assistance. The tube tip is perforated with a needle, and through this opening, the wire is passed into the tube. The tube is then fed over the wire for safe decompression. CONCLUSION: Decreasing the intestinal pressure by safe decompression may avoid one of the causes of leaks.

Safe intestinal decompression in fresh postoperative gastric bypass. Publishing Authors By Initials

C Carrasquilla,M Weiss,J Gianos,

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Safe intestinal decompression in fresh postoperative gastric bypass. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Obesity surgery

VOLUME: 16

Page Numbers: 1256-60

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ISSN: 0960-8923

DAY: 5

MONTH: Sep

YEAR: 2006

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LANGUAGE: eng

NlmUniqueID: 9106714

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AFFILIATION: Florida Center for Surgical Weight Control, Florida Medical Center Hospital, Fort Lauderdale, Florida 33313, USA.

Country: England

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MEDLINETA: Obes Surg

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