Long-term Emergency Department Visits and Readmissions After Laparoscopic Roux-en-Y Gastric Bypass: a Systematic Review

Purpose There is considerable evidence on short-term outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB), but data on long-term outcome is scarce, especially on postoperative emergency department (ED) visits and readmissions. We aim to systematically review evidence on the incidence, indica...

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Bibliographic Details
Published in:Obesity surgery 2021-06, Vol.31 (6), p.2380-2390
Main Authors: van Olst, N., van Rijswijk, A. S., Mikdad, S., Schoonmade, L. J., van de Laar, A. W., Acherman, Y. I. Z., Bruin, S. C., van der Peet, D. L., de Brauw, L. M.
Format: Article
Language:English
Subjects:
Abdomen
Emergency Service, Hospital
Gastric Bypass - adverse effects
Gastrointestinal surgery
Humans
Laparoscopy
Medicine
Medicine & Public Health
Obesity, Morbid - surgery
Original Contributions
Patient Readmission
Postoperative Complications - epidemiology
Retrospective Studies
Surgery
Treatment Outcome
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Summary:Purpose There is considerable evidence on short-term outcomes after laparoscopic Roux-en-Y gastric bypass (LRYGB), but data on long-term outcome is scarce, especially on postoperative emergency department (ED) visits and readmissions. We aim to systematically review evidence on the incidence, indications, and risk factors of ED visits and readmissions beyond 30 days after LRYGB. Materials and Methods A systematic search in PubMed, Scopus, Embase.com , Cochrane Library, and PsycINFO was performed. All studies reporting ED visits and readmissions > 30 days after LRYGB, with ≥ 50 patients, were included. PRISMA statement was used and the Newcastle-Ottawa Scale for quality assessment. Results Twenty articles were included. Six studies reported on ED visits ( n = 2818) and 19 on readmissions ( n = 276,543). The rate of patients with an ED visit within 90 days after surgery ranged from 3.9 to 32.6%. ED visits at 1, 2, and 3 years occurred in 25.6%, 30.0%, and 31.1% of patients. Readmissions within 90 days and at 1-year follow-up ranged from 4.1 to 20.5% and 4.75 to 16.6%, respectively. Readmission was 29% at 2 years and 23.9% at 4.2 years of follow-up. The most common reason for ED visits and readmissions was abdominal pain. Conclusion Emergency department visits and readmissions have been reported in up to almost one in three patients on the long-term after LRYGB. Both are mainly indicated for abdominal pain. The report on indications and risk factors is very concise. A better understanding of ED visits and readmissions after LRYGB is warranted to improve long-term care, in particular for patients with abdominal pains.
ISSN:0960-8923
1708-0428
DOI:10.1007/s11695-021-05286-0