Clinical pathway for laparoscopic gastric bypass.
BACKGROUND
Patients undergoing bariatric surgery are ideal candidates for a clinical pathway, as it is a standardized, common, and elective procedure and most patients have a predictable clinical course.


OBJECTIVE
The aim of developing this clinical pathway is the result of a wide consolidated experience with patients undergoing laparoscopic Roux-en-Y gastric bypass, the purpose of which is to minimize complications without affecting patient care or the outcome of the procedure.


METHODS
The clinical pathway was applied to the 311 patients that received a laparoscopic Roux-en-Y gastric bypass. The clinical pathway includes a temporary matrix, which shows the sequence of events that will occur on each of the days between patient admission and discharge. It also includes medical interventions, nursing care, medication, determinations, physical activity, diet, and information for the patient.


RESULTS
Complications occurred in 36 patients (11.5%): 14 patients (4.5%) during admission and 22 patients (7%) after discharge. Of the 22 patients presenting with complications after discharge, 12 required readmission to hospital (3.8%), and the other 10 were treated on an ambulatory basis.


CONCLUSIONS
We can say that, because of its frequency and predictability, laparoscopic Roux-en-Y gastric bypass is nowadays a procedure for systematization using a clinical pathway, providing it is controlled by a team with a wide experience in bariatric surgery. This clinical pathway is to offer our patients with morbid obesity a laparoscopic Roux-en-Y gastric bypass with the smallest possible range of complications.
Frutos
Maria Dolores
MD
Departamento de Cirugía General, Hospital Universitario Virgen de la Arrixaca, 30120 El Palmar, Murcia, Spain. doloresfrutos@yahoo.es
Luján
Juan
J
Hernández
Quiteria
Q
Valero
Graciela
G
Parrilla
Pascual
P
D000293:Adolescent; D000328:Adult; D000368:Aged; D019091:Critical Pathways; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects; D006760:Hospitalization; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D019990:Perioperative Care / Q000379:methods*; D011183:Postoperative Complications; D016896:Treatment Outcome