Percutaneous Image-Guided Surgery in Complications After Bariatric Surgery

Background:Although bariatric surgery is a standardized procedure, it is not without complications. Image-guided surgery allows minimally invasive resolution of complications, making it ideal for bariatric patients. The objective of this work was to analyze the image-guided surgery approach to postoperative complications of bariatric surgery. Materials and Methods:Retrospective comparative study in patients with complications after bariatric surgery. Patients were included consecutively according to selection criteria. All the patients were treated by the same surgical team. Results:n = 58 patients were recruited. The average age was 47.3 (range 16-62) years; the distribution by sex was male 52% and female 48%. Average body mass index was 42% (+/- 1.26). The associated comorbidities were diabetes mellitus 41% (+/- 0.49), dyslipidemia 41% (+/- 0.49), and high blood pressure 39% (+/- 0.48). Of the total, 39 (67.2%) underwent laparoscopic sleeve gastrectomy (LSG) and 19 (32.8%) under Roux-en-Y Gastric Bypass (RYGB) (P >= .05). Complications reported were leaks/fistulas (with/without abdominal collections) in 94.8% (+/- 0.22), gallstones 3.5% (+/- 0.18), and hemorrhage 1.7% (+/- 0.13). There was no statistically significant difference between the type of bariatric surgery (LSG versus RYGB) and the complications found (P >= .005). There were no intestinal obstructions, strictures or acute gastric dilations, or deaths. The treatment of complications was approached percutaneously (56.9%), endoscopically (29.4%), reoperation laparoscopically (12%), and clinical control (1.7%). Conclusion:The image-guided surgery approach to postoperative complications of bariatric surgery is feasible and safe. Good results are obtained with a decrease in the surgical comorbidities associated with the procedure.