Evidence map›Paper›PMID 28008466›Full record

ArticleSurgical endoscopy2017

Perioperative hemorrhagic complications after laparoscopic sleeve gastrectomy: four-year experience of a bariatric center of excellence.

Francesco De Angelis, Mohamed Abdelgawad, Mario Rizzello, Consalvo Mattia, Gianfranco Silecchia

Abstract read
PubMed Publisher
In one paragraph

Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 1 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Guideline
  2. Trial
  3. Trial
  4. Review
  5. Article
  6. Article
  7. Article
  8. Observational
  9. Observational
  10. Article
  11. Review
  12. Review
  13. Article
  14. Article
  15. Review
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Francesco De AngelisDivision of General Surgery and Bariatric Center of Excellence, Department of Medico-Surgical Sciences and Biotechnologies, La Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
Mohamed AbdelgawadDivision of General Surgery and Bariatric Center of Excellence, Department of Medico-Surgical Sciences and Biotechnologies, La Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
Mario RizzelloDivision of General Surgery and Bariatric Center of Excellence, Department of Medico-Surgical Sciences and Biotechnologies, La Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
Consalvo MattiaUnit of Anesthesia and ICU, Department of Medico-Surgical Sciences and Biotechnologies, La Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy.
Gianfranco SilecchiaDivision of General Surgery and Bariatric Center of Excellence, Department of Medico-Surgical Sciences and Biotechnologies, La Sapienza University of Rome, Via F. Faggiana 1668, 04100, Latina, Italy. gianfranco.silecchia@uniroma1.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundBleeding and gastric fistula are the most common postoperative complications after laparoscopic sleeve gastrectomy (LSG). The long stapler line represents the most frequent source of bleeding, which ranges between 0 and 20%. The aim of this retrospective study was to analyze the 4-year experience of a high-volume center with respect to the prevention and management of perioperative LSG bleeding.

methodsThe prospectively maintained database from June 2012 to June 2016 was reviewed. Outcomes, especially perioperative bleeding (until patient discharge), its management, and follow-ups, were analyzed.

resultsOut of 870 LSG (603 females, 267 males), 31 cases (3.5%) of postoperative complications were registered: bleeding was the most frequent complication (1.9%). Hemoperitoneum was managed laparoscopically in 9/17 patients (52.9%) with only one conversion to laparotomy (11.1%). Conservative treatment successfully controlled bleeding in 8/17 patients (47.1%). However, four patients (50%) developed an infected hematoma; two of them were treated conservatively with a CT-guided drainage, and the other two were complicated by late gastric leak treated laparoscopically. No mortalities occurred in the investigated cases.

conclusionsIn a high-volume center, the expected incidence of bleeding after LSG is 1.7% even after the adoption of all preventive strategies. The intraoperative protocol for detecting silent bleeding was effective, and no cases of bleeding were observed since its application. Our findings showed that the conservative management of postoperative bleeding should be considered as a high-risk condition for late leakage.

Indexed as

GastrectomyHemostatic TechniquesLaparoscopyAdolescentAdultAgedFemaleFollow-Up StudiesHumansIncidenceMaleMiddle AgedObesity, MorbidPostoperative HemorrhageRetrospective StudiesTreatment OutcomeBleedingHematomaHemostasisLate leak complications managementSleeve gastrectomy

Identifiers

PMID28008466

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.