title: Endoscopic management of early GI hemorrhage after laparoscopic gastric bypass.
abstract: 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.
authors.affiliation: Gastroenterology Department, University of Barcelona, Barcelona, Spain.
authors.forename: Glòria
authors.initials: G
authors.lastname: Fernández-Esparrach
authors.forename: Josep M
authors.initials: JM
authors.lastname: Bordas
authors.forename: Maria
authors.initials: M
authors.lastname: Pellisé
authors.forename: Antonio Z
authors.initials: AZ
authors.lastname: Gimeno-García
authors.forename: Antonio
authors.initials: A
authors.lastname: Lacy
authors.forename: Salvadora
authors.initials: S
authors.lastname: Delgado
authors.forename: Andrés
authors.initials: A
authors.lastname: Cárdenas
authors.forename: Angels
authors.initials: A
authors.lastname: Ginès
authors.forename: Oriol
authors.initials: O
authors.lastname: Sendino
authors.forename: Dulce
authors.initials: D
authors.lastname: Momblán
authors.forename: Michel
authors.initials: M
authors.lastname: Zabalza
authors.forename: Josep
authors.initials: J
authors.lastname: Llach
mesh_terms: 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
chemical_list: D012597:Sclerosing Solutions; D014662:Vasoconstrictor Agents; D000077423:Polidocanol; D011092:Polyethylene Glycols; D004837:Epinephrine