Mucosal tonometry as early warning of gastrojejunal leak in laparoscopic Roux-en-y Gastric bypass

Javier Pascual-Ramírez, Luis G. Collar Viñuelas, Jesús Martín, Ginés Bernal, Alfredo Bosque Castro, Nieves García-Serrano

Research output: Contribution to journalArticlepeer-review

Abstract

The laparoscopic Roux-en-Y gastric bypass (LRYGB) is the standard surgical procedure for morbidly obese patients in many centers worldwide. The gastrojejunal anastomosis (GJA) leak has a 2% incidence and a 10% mortality. This prospective study aims to test gastroenteric tonometry as an early warning of GJA leak risk. A nasogastric tube with tonometric capability was used to monitor gastroenteric mucosal carbon dioxide partial pressure (PgeCO2) in 32 consecutive patients during the first 24 to 72 postoperative hours after LRYGB. Sensitivity was 100%, specificity 96.77%, likelihood ratio 31, and area under receiver operating characteristic curve 0.984. The only early gastrojejunal leak occurred to the patient with maximal PgeCO2 (13.9 kPa) of the cohort. The remaining patients kept a PgeCO2 below 11 kPa except one; none of these developed early GJA leak. Mucosal gastroenteric tonometry may be a useful predictor of early GJA leak of the LRYGB.

Original languageEnglish (US)
Pages (from-to)843-846
Number of pages4
JournalObesity Surgery
Volume22
Issue number5
DOIs
StatePublished - May 2012
Externally publishedYes

Keywords

  • Bariatric surgery
  • Gastric tonometry
  • Gastrojejunal anastomosis leak
  • Laparoscopic Roux-en-Y gastric bypass

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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