The hidden endoscopic burden of sleeve gastrectomy and its comparison with Roux-en-Y gastric bypass
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AbstractBACKGROUND:This study aimed to assess the endoscopic burden of bariatric surgical procedures at our trust. This is an enhanced parallel study to "The Hidden Endoscopic burden of Roux-en-Y Gastric Bypass" published in Frontline Gastroenterology in 2013 incorporating the data for sleeve gastrectomy and comparison with Roux-en-Y gastric bypass (RYGB). METHODS:This is a retrospective study that included 211 patients undergoing sleeve gastrectomy over a 34-month period. We utilized previously collected data for the RYGB patient cohort which included 553 patients over a 29-month period. We searched our hospital endoscopic database for patients who underwent post-operative endoscopy for indications related to their surgery. RESULTS:16.6% of the sleeve gastrectomy patients required post-operative endoscopy, of whom 11.4% underwent therapeutic procedures. This compares to 20.4% of the RYGB cohort of whom 50.4% needed therapeutic procedures (P<0.001). 1.9% of sleeve gastrectomy patients encountered a post-operative staple line leak and collectively required 29 endoscopic procedures. One patient also developed stricturing (0.47%) requiring 18 pneumatic dilatations. 11.4% of the RYGB cohort developed an anastomotic stricture requiring 57 balloon dilatation procedures. To date, these procedures have accumulated an equivalent cost of €159,898 in endoscopy tariffs, or €177 per RYGB and €373 per sleeve gastrectomy performed. CONCLUSIONS:Bariatric surgery can have significant implications in terms of patient morbidity and financial cost. Having a local bariatric surgery service increases the demand for endoscopic procedures in our hospital, both in investigating for and dealing with post-operative complications. Provision of extra resources and expertise needs to be taken into account.
CitationArndtz, K., Steed, H., Hodson, J. and Manjunath, S. (2016) The hidden endoscopic burden of sleeve gastrectomy and its comparison with Roux-en-Y gastric bypass, Annals of Gastroenterology, 29(1), pp. 44-49.
PublisherHellenic Society of Gastroenterology
JournalAnnals of Gastroenterology
PubMed ID26752949 (pubmed)
Description© Published by Hellenic Society of Gastroenterology. This is an open access article available under a Creative Commons licence. The published version can be accessed at the following link on the publisher’s website: http://www.annalsgastro.gr/index.php/annalsgastro/article/view/2284/1663
Except where otherwise noted, this item's license is described as Licence for published version: Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International