Endoscopic management of early GI hemorrhage after laparoscopic gastric bypass.
BACKGROUND
Early upper GI hemorrhage (UGH) is a potential complication after laparoscopic Roux-en-Y gastric bypass (RYGBP), and early reoperative intervention is the most accepted treatment. Experience with endoscopic treatment is limited.


OBJECTIVE
Our purpose was to describe the role of endoscopy and injection therapy in the management of early UGH after laparoscopic RYGBP.


METHODS
Case series study.


METHODS
Endoscopy Unit, Hospital Clínic, University of Barcelona, Barcelona, Spain.


METHODS
We describe the endoscopic treatment of 6 patients with early UGH within 24 hours after a RYGBP.


METHODS
Upper endoscopy was performed in all 6 cases. The origin of the bleeding was identified at the staple line in all cases, and epinephrine alone or combined with polidocanol was successfully injected in 5 of 6 patients.


RESULTS
Endoscopic therapy arrested active bleeding without any complications in all cases without the need for further surgery or endoscopic treatments.


CONCLUSIONS
Our experience is limited to 6 cases.


CONCLUSIONS
Early postoperative UGH after RYGBP may be adequately controlled with endoscopic treatment and may obviate the need for surgery. Further data are necessary to evaluate the safety and the efficacy of this approach.
Fernández-Esparrach
Glòria
G
Gastroenterology Department, University of Barcelona, Barcelona, Spain.
Bordas
Josep M
JM
Pellisé
Maria
M
Gimeno-García
Antonio Z
AZ
Lacy
Antonio
A
Delgado
Salvadora
S
Cárdenas
Andrés
A
Ginès
Angels
A
Sendino
Oriol
O
Momblán
Dulce
D
Zabalza
Michel
M
Llach
Josep
J
D000328:Adult; D015331:Cohort Studies; D016099:Endoscopy, Gastrointestinal; D004837:Epinephrine / Q000008:administration & dosage; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology* / Q000628:therapy*; D016558:Hemostasis, Endoscopic / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D000077423:Polidocanol; D011092:Polyethylene Glycols / Q000008:administration & dosage; D012597:Sclerosing Solutions / Q000008:administration & dosage; D016896:Treatment Outcome; D014662:Vasoconstrictor Agents / Q000008:administration & dosage
D012597:Sclerosing Solutions; D014662:Vasoconstrictor Agents; D000077423:Polidocanol; D011092:Polyethylene Glycols; D004837:Epinephrine