The effect of routine division of the greater omentum on small bowel obstruction after Roux-en-Y gastric bypassShow others and affiliations
2023 (English)In: Surgery for Obesity and Related Diseases, ISSN 1550-7289, E-ISSN 1878-7533, Vol. 19, no 3, p. 178-183Article in journal (Refereed) Published
Abstract [en]
BACKGROUND: It remains unknown whether routine division of the greater omentum during laparoscopic Roux-en-Y gastric bypass (LRYGB) influences the risk for small bowel obstruction (SBO) after RYGB.
OBJECTIVE: To evaluate the effect of omental division on SBO after LRYGB stratified by handling of the mesenteric defects.
SETTING: Nationwide, registry-based.
METHODS: In this registry-based cohort study, 40,517 patients who underwent LRYGB in Sweden within the period from January 1, 2007, to December 31, 2019, with data from the Scandinavian Obesity Surgery Registry (SOReg) were included. The study was based on combined data from the SOReg, the National Patient Register, the Swedish Prescribed Drugs Register, and the Total Population Registry. The main outcome was reoperation for SBO.
RESULTS: During a follow-up period of 5.9 ± 2.6 years, the cumulative incidence of SBO was 11.2% in the nondivision group compared with 9.7% among patients with divided omentum (hazard ratio [HR] = .83, 95% confidence interval [CI]: .77-.89, P < .001). The association was seen in patients without mesenteric defects closure (HR = .69, 95% CI: .61-.78, P < .001) as well as patients with closed mesenteric defects (HR = .80, 95% CI: .74-.87, P < .001).
CONCLUSION: Division of the greater omentum is associated with reduced risk for SBO after antecolic, antegastric LRYGB and should be considered as a complement to mesenteric defects closure to further reduce the risk for SBO after LRYGB.
Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 19, no 3, p. 178-183
Keywords [en]
Bariatric surgery, Obesity, Omentum, Postoperative complication, Small bowel obstruction
National Category
Surgery
Identifiers
URN: urn:nbn:se:oru:diva-101751DOI: 10.1016/j.soard.2022.09.006ISI: 000948542800001PubMedID: 36207233Scopus ID: 2-s2.0-85139302847OAI: oai:DiVA.org:oru-101751DiVA, id: diva2:1702981
Funder
Stockholm County Council
Note
Funding agencies:
Örebro County Council OLL-939106
Strategic Research Programme in Diabetes
2022-10-122022-10-122023-03-30Bibliographically approved