Late perforation of the jejuno-jejunal anastomosis after laparoscopic Roux-en-Y gastric bypass

David Goitein, Pavlos K. Papasavas, Daniel J. Gagné, Philip F. Caushaj

Research output: Contribution to journalArticlepeer-review

Abstract

Roux-en-Y gastric bypass (RYGBP) is the most commonly performed operation for the treatment of morbid obesity in the USA. Complications related to the jejuno-jejunal (J-J) anastomosis include postoperative leak, staple-line bleeding and obstruction. We present 3 cases of perforation at the J-J anastomosis occurring more than 30 days after surgery. 3 morbidly obese patients underwent laparoscopic RYGBP. The side-to-side J-J anastomosis was created with a linear stapler, and the anastomotic defect was closed with a running absorbable suture. All 3 patients had uneventful recoveries, but presented 7 to 8 weeks postoperatively with acute abdominal pain and peritoneal signs. Exploratory laparoscopy in these patients revealed a perforation at the J-J anastomosis. No apparent reason for the perforation was found in 2 patients. These perforations were repaired laparoscopically with absorbable suture. The third patient had an obstruction at the J-J anastomosis from an phytobezoar and required conversion to open technique due to limited pneumoperitoneum. All 3 patients recovered uneventfully. Late perforation of the J-J anastomosis is a very rare complication. Primary laparoscopic repair is a feasible and safe choice of treatment.

Original languageEnglish
Pages (from-to)880-882
Number of pages3
JournalObesity Surgery
Volume15
Issue number6
DOIs
StatePublished - Jun 2005
Externally publishedYes

Keywords

  • Complications
  • Laparoscopic
  • Roux-en-Y gastric bypass

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