Diagnostic laparoscopy for chronic abdominal pain after gastric bypass.
BACKGROUND
To evaluate, in an observational study, the utility of diagnostic laparoscopy as a tool to evaluate patients with abdominal pain of unknown etiology after gastric bypass surgery.


METHODS
A retrospective analysis was performed of data from patients who had undergone laparoscopy for diagnosis or treatment of abdominal pain. This study included 13 patients with negative preoperative radiographic and/or endoscopic findings.


RESULTS
A total of 13 patients who had undergone Roux-en-Y gastric bypass underwent diagnostic laparoscopy for abdominal pain. The findings included internal hernia (4), adhesions (3), ventral hernia (2), partial small bowel obstruction (1), and chronic cholecystitis (1). There were 2 negative laparoscopies, while a diagnosis was made in 85%. After an average follow-up of 3.2 months, 7 of 11 patients had unresolved abdominal pain and 4 patients experienced pain resolution (2 patients were lost to follow-up).


CONCLUSIONS
The results from this small retrospective study suggest that significant pathologic findings can be identified in most patients who have negative preoperative evaluation findings; however, the efficacy of diagnostic laparoscopy to eliminate pain in this patient population requires additional study. Despite the potential complications, we believe that diagnostic laparoscopy has a role in the diagnosis and treatment of chronic abdominal pain after gastric bypass.
Pitt
Tracy
T
Bariatric and Metabolic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH 44195, USA.
Brethauer
Stacy
S
Sherman
Vadim
V
Udomsawaengsup
Suthep
S
Metz
Matt
M
Chikunguwo
Silas
S
Chand
Bipan
B
Schauer
Philip
P
D015746:Abdominal Pain / Q000175:diagnosis* / Q000209:etiology; D000328:Adult; D002908:Chronic Disease; D003937:Diagnosis, Differential; D005260:Female; D005500:Follow-Up Studies; D015390:Gastric Bypass / Q000009:adverse effects*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D009767:Obesity, Morbid / Q000601:surgery; D010149:Postoperative Pain / Q000175:diagnosis* / Q000209:etiology; D015203:Reproducibility of Results; D012189:Retrospective Studies