title: Case-Control Study of Postoperative Blood Pressure in Patients with Hemorrhagic Complications after Laparoscopic Sleeve Gastrectomy and Matched Controls.
abstract: Laparoscopic sleeve gastrectomy is associated with a moderate risk of hemorrhagic complications (HC). There is a debate regarding the relationship between HC and high blood pressure in postoperative period.
  
  
  
  The aim is to clarify whether the postoperative blood pressure is an independent risk factor for hemorrhagic complications after laparoscopic sleeve gastrectomy.
  
  
  
  Medical records of 522 patients were reviewed. A case-control study of postoperative blood pressure was undertaken in patients with bleeding after LSG and matched controls. Patients who required surgical revision, due to the hemorrhagic complications within 72 hours, were identified as the cases. Controls were matched (1:1) with cases by age (±1 year), gender (female versus male), staple line reinforcement (running suture versus haemostatic clips) and surgeon's experience (>50 or <50 LSG procedures per year). 12-hour postoperative blood pressure was recorded.
  
  
  
  17 patients after LSG with HC in postoperative period were matched with 17 controls. Patients who experienced hemorrhagic complications after LSG had non statistically significant decreased mean systolic blood pressure (mmHg) in 12 hours observation (130.7 ± 12.9 versus 139.1 ± 10.8); p = 0.15; mean difference - 11.6 (95% CI -29.5 - 6.1). Mean 12 hour diastolic pressure was also comparable. The detailed analysis of controls revealed a significantly higher systolic blood pressure measurements in 5th and 11th hour postoperatively, as well as higher diastolic blood pressure in 12th hour postoperatively. However, the differences were not clinically significant.
  
  
  
  Compared with closely matched control subjects, patients with HC after LSG have decreased systolic blood pressure without clinical significance.
authors.affiliation: Bariatric and Metabolic Surgery - Geauga Medical Center, Case Western Reserve University School of Medicine, 10900 Euclid Ave. T402, Cleveland, OH, 44106, USA. janiken@gmail.com.|Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów, 04-141, Warszawa, Poland. janiken@gmail.com.
authors.forename: Michał Robert
authors.initials: MR
authors.lastname: Janik
authors.affiliation: Bariatric and Metabolic Surgery - Geauga Medical Center, Case Western Reserve University School of Medicine, 10900 Euclid Ave. T402, Cleveland, OH, 44106, USA.|Faculty of Medicine and Health Sciences, Jan Kochanowski University, Kielce, Poland.
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rogula
authors.affiliation: Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów, 04-141, Warszawa, Poland.
authors.forename: Piotr
authors.initials: P
authors.lastname: Kowalewski
authors.affiliation: Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów, 04-141, Warszawa, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Walędziak
authors.affiliation: 2nd Department of Surgery UJCM, Jagiellonian University, ul. Kopernika 21, 31-501, Kraków, Poland.
authors.forename: Maciej
authors.initials: M
authors.lastname: Matłok
authors.affiliation: Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów, 04-141, Warszawa, Poland.
authors.forename: Jakub
authors.initials: J
authors.lastname: Brągoszewski
authors.affiliation: Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów, 04-141, Warszawa, Poland.
authors.forename: Andrzej
authors.initials: A
authors.lastname: Kwiatkowski
authors.affiliation: Department of General, Oncologic, Metabolic and Thoracic Surgery, Military Institute of Medicine, Szaserów, 04-141, Warszawa, Poland.
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Paśnik
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D006973:Hypertension / Q000209:etiology*; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000150:complications / Q000601:surgery*; D011184:Postoperative Period; D012086:Reoperation; D018570:Risk Assessment; D012307:Risk Factors; D017792:Surgical Stapling / Q000009:adverse effects / Q000379:methods; D055815:Young Adult
keywords: Bariatric surgery; Bleeding; Blood pressure; Complications; Hemorrhagic complications; Postoperative hypertension; Sleeve gastrectomy