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DOI: 10.1055/s-0042-113882
Komplikationen bei bariatrischen Patienten: diagnostisches Vorgehen und Management
Publication History
Publication Date:
14 December 2016 (online)
Bariatrische Operationen werden in Deutschland überwiegend routinemäßig in minimalinvasiver Technik durchgeführt. Ein erfolgreiches Komplikationsmanagement beginnt hier bereits im Operationssaal mit geeigneten Lagerungstechniken und präventiven Maßnahmen. So sind beispielsweise Schwerlastoperationstische mit breiten Arm- und Beinschienen zur Vermeidung von Druckstellen am Patienten oder hydraulische Lagerungshilfen notwendig. Ein geeignetes chirurgisches Instrumentarium wie lange Operationsinstrumente, Stapler und Trokare sollten vorhanden sein.
Dieser Beitrag soll darüber hinaus einen Überblick über mögliche spezielle Komplikationen bei adipösen Patienten mit bariatrischen Operationen und Vorschläge für Strategien zur Vermeidung und zum Management typischer Störungen geben.
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Literatur
- 1 German Bariatric Surgery Registry. Auswertung (Deutschland) 2005 – 2014 (Stand: Juni 2015). An-Institut für Qualitätssicherung in der operativen Medizin gGmbH an der Otto-von-Guericke Universität Magdeburg. Magdeburg: An-Institut; 2014
- 2 Shah SS, Todkar JS, Shah PS. Buttressing the staple line: a randomized comparison between staple-line reinforcement versus no reinforcement during sleeve gastrectomy. Obes Surg 2014; 24: 2014-2020
- 3 Dapri G, Cadière GB, Himpens J. Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing three different techniques. Obes Surg 2010; 20: 462-467
- 4 Musella M, Milone M, Bellini M et al. Laparoscopic sleeve gastrectomy. Do we need to oversew the staple line?. Ann Ital Chir 2011; 82: 273-277
- 5 Diamantis T, Apostolou K, Alexandrou A et al. Review of long-term weight loss results after laparoscopic sleeve gastrectomy. Surg Obes Relat Dis 2014; 10: 177-183
- 6 Iannelli A, Dainese R, Piche T et al. Laparoscopic sleeve gastrectomy for morbid obesity. World J Gastroenterol 2008; 14: 821-827
- 7 Yuval J, Mintz Y, Cohen M et al. The effects of bougie caliber on leaks an excess weight loss following laparoscopic sleeve gastrectomy. Is there an ideal bougie size?. Obes Surg 2013; 23: 1685-1691
- 8 Spivak H, Rubin M, Sadot E et al. Laparoscopic sleeve gastrectomy using 42-French versus 32-French bougie. Obes Surg 2014; 24: 1095
- 9 Rosenthal RJ, Diaz AA, Arvidsson D et al. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of > 12000 cases. Surg Obes Relat Dis 2012; 8: 8-19
- 10 Cal P, Deluca L, Jakob T et al. Laparoscopic sleeve gastrectomy with 27 versus 39 Fr bougie calibration: a randomized controlled trial. Surg Endosc 2016; 30: 1812-1815
- 11 Parikh M, Issa R, McCrillis A et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy. Ann Surg 2013; 257: 231-237
- 12 Rausa E, Bonavina L, Asti E et al. Rate of death and complications in laparoscopic and open Roux-en-Y gastric bypass. A metaanalysis and metaregression analysis on 69,494 patients. Obes Surg 2016; 26: 1956-1963
- 13 Dang JT, Switzer NJ, Wu JS et al. Gastric band removal in revisional bariatric surgery, one-step versus two-step: a systematic review and meta-analysis. Obes Surg 2016; 26: 866-873
- 14 Sakran N, Assalia A, Keidar A et al. Gastrobronchial fistula as a complication of bariatric surgery: a series of 6 cases. Obes Facts 2012; 5: 538-545
- 15 Nguyen D, Dip F, Hendricks L et al. The surgical management of complex fistulas after sleeve gastrectomy. Obes Surg 2016; 26: 245-250
- 16 Palermo M, Acquafresca PA, Rogula T et al. Late surgical complications after gastric by-pass: a literature review. Arq Bras Cir Dig 2015; 28: 139-143
- 17 Nguyen NT, Stevens CM, Wolfe BM et al. Incidence and outcome of anastomotic stricture after laparoscopic gastric bypass. J Gastrointest Surg 2003; 7: 997-1003
- 18 Murad-jr AJ, Scheibe CL, Campelo GP et al. Fixing jejunal maneuver to prevent Petersen hernia in gastric bypass. Arq Bras Cir Dig 2015; 28: 69-72
- 19 Himpens J, Verbrugghe A, Cadière GB et al. Long-term results of laparoscopic Roux-en-Y gastric bypass: evaluation after 9 years. Obes Surg 2012; 22: 1586-1593
- 20 Kristensen SD, Floyd AK, Naver L et al. Does the closure of mesenteric defects during laparoscopic gastric bypass surgery cause complications?. Surg Obes Relat Dis 2015; 11: 459-464
- 21 Singla S, Guenthart BA, May L et al. Intussusception after laparoscopic gastric bypass surgery: an underrecognized complication. Minim Invasive Surg 2012; 2012: 464853
- 22 Daellenbach L, Suter M. Jejunojejunal intussusception after Roux-en-Y gastric bypass: a review. Obes Surg 2011; 21: 253-263