J Korean Surg Soc.  2008 May;74(5):347-351.

The Importance of Clinical Indicators for Detecting Postoperative Complications Following Laparoscopic Sleeve Gastrectomy

Affiliations
  • 1Department of Surgery, College of Medicine, Pochun Cha University, Seongnam, Korea. surgeryhan@cha.ac.kr
  • 2Mediheal Clinic, Seoul, Korea.

Abstract

PURPOSE: The significant drastic complications of performing laparoscopic sleeve gastrectomy (LSG) in morbidly obese patients are gastric staple line leakage and bleeding. The aim of our study is to evaluate the efficacy of the clinical data for detecting postoperative complications after LSG.
METHODS
The study enrolled 150 consecutive patients who underwent LSG from January 2003 to July 2006. When abnormal data (heart rate > or = 10/min, or temperature > or = 7.5degrees C) was detected on postoperative day 1, then laboratory tests (blood, urine, chest X-ray and abdominal sonogram) and water soluble gastrografin UGIS were performed to detect the postoperative complications after LSG (group A). The patients who had normal postoperative clinical data (group B) were compared with group A.
RESULTS
Of the 150 patients who underwent LSG, 9 patients (6%) had postoperative complications. Two patients had major complications: 1 case of leakage (0.6%) and 1 case of delayed bleeding (0.6%), and 4 patients had minor complications in group A. But no major complications were detected in group B (P<0.01). The heart rate and body temperature in group A were significantly faster and higher than those in group B (P<0.01). Especially, 2 patients who had major complications had severe tachycardia over 120 beats per minute (bpm). However, when the body temperature of a patient was elevated, there was no high grade fever in all the cases ( > 39degrees C).
CONCLUSION
Evidence of tachycardia or a high body temperature may be useful to detect major complications after LSG. We also recommend performing laboratory test and UGIS when clinically indicated.

Keyword

Laparoscopic sleeve gastrectomy; Morbid obesity; Complications; Tachycardia; Fever

MeSH Terms

Body Temperature
Diatrizoate Meglumine
Fever
Gastrectomy
Heart Rate
Hemorrhage
Humans
Obesity, Morbid
Postoperative Complications
Tachycardia
Thorax
Diatrizoate Meglumine
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