Evidence map›Paper›PMID 30232617›Full record

ArticleSurgical endoscopy2019

Postoperative bleeding after laparoscopic Roux en Y gastric bypass: predictors and consequences.

Syed Nabeel Zafar, Kaylie Miller, Jessica Felton, Eric S Wise, Mark Kligman

Registry-linked trialAbstract read
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In one paragraph

Article in Surgical endoscopy, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07098780 (Role of Tranexamic Acid in Reducing Hemorrhagic Events in Bariatric Surgery), which is not on this map. Cited by 25 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 2 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.

NCT07098780 phase4recruitingnot on this mapstarted 2023, after this paper: background citation

Role of Tranexamic Acid in Reducing Hemorrhagic Events in Bariatric Surgery

TypeinterventionalSponsorPatel Hospital, PakistanRan2023 to 2025Enrolled140ConditionsHemorrhage, Bariatric Surgery, Obesity, MorbidArmsTranexamic Acid, Normal Saline (Placebo)
3 · Its place in the literature

Who cites it

25 citing papers in PubMed, 2 syntheses or guidelines pooled it.

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  5. Association of venous thromboembolism prophylaxis with postoperative bleeding in bariatric surgery: an observational study.Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery · 2026
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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.

Syed Nabeel ZafarDepartment of Surgery, University of Maryland Medical Center, Baltimore, MD, USA.ORCID http://orcid.org/0000-0003-3843-9687
Kaylie MillerSchool of Medicine, University of Maryland, Baltimore, MD, USA.
Jessica FeltonDepartment of Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
Eric S WiseDepartment of Surgery, University of Maryland Medical Center, Baltimore, MD, USA.
Mark KligmanDepartment of Surgery, University of Maryland Medical Center, Baltimore, MD, USA. MKligman@som.umaryland.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundLaparoscopic Roux-en-Y gastric bypass (LRYGB) is a common, safe and effective bariatric procedure. Bleeding is a significant source of postoperative morbidity. We aimed to determine the incidence, outcomes, and predictors of postoperative bleeding after LRYGB.

methodsLRYGB patients included in the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) 2015 dataset were identified. Preoperative and intraoperative factors were tested for associations with bleeding using univariable and multivariable logistic regression analysis. Outcomes of length of stay, in-hospital mortality, 30-day mortality, discharge disposition, and 30-day complications among patients with and without clinically significant postoperative bleeding were compared using multivariable regression.

resultsIn the 43,280 LRYGB patients included in this analysis, postoperative bleeding occurred in 652 (1.51%) patients. Of these, 165 (25.3%) underwent a re-operation and 97 (14.9%) underwent an unplanned endoscopy for 'bleeding'. Postoperative bleeding was associated with a longer median postoperative length of stay (4 vs. 2 days), higher in-hospital mortality (1.23 vs. 0.04%), higher 30-day mortality (1.38 vs. 0.15%), discharge to an extended-care facility (3.88 vs. 0.6%), and higher rates of major complications (all P < 0.05). Independent predictors of postoperative bleeding included; a history of renal insufficiency (OR 2.55, 95% CI 1.43-4.52), preoperative therapeutic anticoagulation (OR 2.44, 95% CI 1.69-3.53), and revisional surgery (OR 1.45, 95% CI 1.06-1.97). Intraoperative associated factors included conversions (OR 3.37, 95% CI 1.42-7.97), and drain placement (OR 1.40, 95% CI 1.18-1.67). Robotic approaches resulted in independently lower postoperative bleeding rates (OR 0.50, 95% CI 0.32-0.77).

conclusionsPostoperative bleeding occurs in 1.5% of patients undergoing a LRYGB and is associated with significantly increased morbidity and mortality. We have identified patient and operative factors that are independently associated with postoperative bleeding.

Indexed as

LaparoscopyPostoperative ComplicationsPostoperative HemorrhageAdultAgedFemaleGastric BypassHospital MortalityHumansIncidenceLength of StayMaleMiddle AgedObesity, MorbidQuality ImprovementBariatric surgeryComplicationsOutcomesWeight loss surgery

Identifiers

PMID30232617

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Registered trials

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.