World Journal of Emergency Surgery (Sep 2022)
Operative management of acute abdomen after bariatric surgery in the emergency setting: the OBA guidelines
- 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 Parasas,
- Yoram Kluger,
- Elias Chahine,
- Vanni Agnoletti,
- Gustavo Fraga,
- Walter L. Biffl,
- Fausto Catena
Affiliations
- Belinda De Simone
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals
- Elie Chouillard
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals
- Almino C. Ramos
- GastroObesoCenter Institute for Metabolic Optimization
- Gianfranco Donatelli
- Interventional Endoscopy and Endoscopic Surgery, Hôpital Privé Des Peupliers
- Tadeja Pintar
- Department of Abdominal Surgery, Ljubljana University Medical Centre
- Rahul Gupta
- Division of Minimally Invasive Surgery and Bariatrics, Beth Israel Deaconess Medical Center
- Federica Renzi
- General Surgery and Trauma Team, ASST Niguarda
- Kamal Mahawar
- South Tyneside and Sunderland NHS Foundation Trust
- Brijesh Madhok
- East Midlands Bariatric and Metabolic Institute, University Hospitals of Derby and Burton NHS Trust
- Stefano Maccatrozzo
- Department of Bariatric Surgery, Istituto Di Cura Beato Matteo
- Fikri M. Abu-Zidan
- Department of Surgery, College of Medicine and Health Sciences, UAE University
- Ernest E. Moore
- Denver Health System - Denver Health Medical Center
- Dieter G. Weber
- Department of General Surgery, Royal Perth Hospital, University of Western Australia
- Federico Coccolini
- Department of Emergency and Trauma Surgery, Pisa University Hospital
- Salomone Di Saverio
- Department of Surgery, Madonna Del Soccorso Hospital
- Andrew Kirkpatrick
- Department of General, Acute Care, Abdominal Wall Reconstruction, and Trauma Surgery, Foothills Medical Centre
- Vishal G. Shelat
- Department of General Surgery, Tan Tock Seng Hospital
- Francesco Amico
- Department of Surgery, John Hunter Hospital and The University of Newcastle
- Emmanouil Pikoulis
- 3Rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA)
- Marco Ceresoli
- General Surgery, Monza University Hospital
- Joseph M. Galante
- University of California
- Imtiaz Wani
- Government Gousia Hospital
- Nicola De’ Angelis
- Service de Chirurgie Digestive Et Hépato-Bilio-Pancréatique - DMU CARE, Hôpital Henri Mondor
- Andreas Hecker
- Department of General and Thoracic Surgery, University Hospital of Giessen
- Gabriele Sganga
- Emergency Surgery and Trauma, Fondazione Policlinico Universitario A. Gemelli IRCCS, Università Cattolica del Sacro Cuore
- Edward Tan
- Department of Emergency Medicine, Radboud University Medical Center
- Zsolt J. Balogh
- Department of Traumatology, John Hunter Hospital and University of Newcastle
- Miklosh Bala
- Trauma and Acute Care Surgery Unit, Hadassah - Hebrew University Medical Center
- Raul Coimbra
- Riverside University Health System Medical Center, Loma Linda University School of Medicine
- Dimitrios Damaskos
- General and Emergency Surgery, Royal Infirmary of Edinburgh, University of Edinburgh
- Luca Ansaloni
- Department of Surgery, Pavia University Hospital
- Massimo Sartelli
- Department of General Surgery, Macerata Hospital
- Nikolaos Parasas
- 3Rd Department of Surgery, Attikon General Hospital, National and Kapodistrian University of Athens (NKUA)
- Yoram Kluger
- Division of General Surgery, Rambam Health Care Campus
- Elias Chahine
- Department of Emergency, Digestive and Metabolic Minimally Invasive Surgery, Poissy and Saint Germain en Laye Hospitals
- Vanni Agnoletti
- Department of Emergency and Trauma Surgery, Bufalini Hospital
- Gustavo Fraga
- School of Medical Sciences, University of Campinas (Unicamp)
- Walter L. Biffl
- Department of Trauma and Acute Care Surgery, Scripps Memorial Hospital La Jolla
- Fausto Catena
- Department of Emergency and Trauma Surgery, Bufalini Hospital
- DOI
- https://doi.org/10.1186/s13017-022-00452-w
- Journal volume & issue
-
Vol. 17,
no. 1
pp. 1 – 34
Abstract
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.
Keywords
- Abdominal pain
- Bariatric surgery
- Acute abdomen
- Long-term complication
- Emergency surgery
- Sleeve gastrectomy