Format

Send to

Choose Destination
Surg Obes Relat Dis. 2014 Jan-Feb;10(1):171-6. doi: 10.1016/j.soard.2013.09.008. Epub 2013 Sep 21.

The role of drainage after Roux-en-Y gastric bypass for morbid obesity: a systematic review.

Author information

1
Bariatric and Metabolic Surgery Unit, Careggi University Hospital, Florence, Italy. Electronic address: gadiel.liscia@gmail.com.
2
Bariatric and Metabolic Surgery Unit, Careggi University Hospital, Florence, Italy.

Abstract

BACKGROUND:

Intraperitoneal drainage after gastrointestinal surgery is still routinely used in many hospitals. The objective of this study was to determine the evidence-based value of routine drainage after Roux-en-Y gastric bypass (RYGB).

METHODS:

An electronic search of the MEDLINE, Cochrane, and Embase databases from 2002 to 2012 was performed to identify articles analyzing the use of drainage after RYGB, its efficacy in determining the presence of an anastomotic leak, and its role in nonoperative treatment of the leakage.

RESULTS:

Eighteen articles were identified: 6 nonrandomized prospective cohort studies, 1 cohort retrospective study that compared routine drainage versus no drainage, 11 retrospective cohort studies, and no randomized controlled trials (RCTs). The sensitivity of drainage in detecting postoperative leakage varied between 0% and 94.1% in 10 articles (3 prospective and 6 retrospective) reporting data about this matter. The efficacy of drainage for the nonoperative treatment of postoperative leakage could be estimated in 11 articles (5 prospective and 6 retrospective) and varied between 12.5% and 100%. Only 2 studies reported data about nonoperative treatment of leakage without drainage, which was pursued in 0% and 33% of patients, respectively.

CONCLUSION:

Evidence-based recommendations on the use of drainage after RYGB cannot be given. Without RCTs, the value of routine drainage cannot be ascertained.

KEYWORDS:

Bariatric surgery; Drain; Gastric bypass; Leak

PMID:
24355318
DOI:
10.1016/j.soard.2013.09.008
[Indexed for MEDLINE]

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center