Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2014 Mar 20;3(1):e13110.
doi: 10.5812/atr.13110. eCollection 2014 Mar.

Functional abdominal pain syndrome in morbidly obese patients following laparoscopic gastric bypass surgery

Mohammad Eidy  1 , Abdolreza Pazouki  2 , Fahimeh Raygan  3 , Yazdan Ariyazand  2 , Mohadeseh Pishgahroudsari  2 , Fatemeh Jesmi  2
Affiliations

Functional abdominal pain syndrome in morbidly obese patients following laparoscopic gastric bypass surgery

Mohammad Eidy et al. Arch Trauma Res. .

Abstract

Background: Roux-en-Y gastric bypass surgery (RYGBP) is one of the most common bariatric surgeries, which is being performed using various techniques like gastrojejunostomy by hand swen, linear or circular stapler. Abdominal pain is a common complaint following laparoscopic gastric bypass procedure (LGBP), which has different aetiologies, such as overeating, adhesion, internal herniation, bile reflux and many more. In this study LGBP was performed in an ante-colic ante-gastric pattern in a double loop manner and the prevalence and distribution of pain in morbidly obese patients undergoing LGBP was assessed.

Objectives: The aim of this study was to analyze the distribution and frequency of post LGBP pain in morbidly obese patients.

Patients and methods: This study was performed on 190 morbidly obese patients referred to Hazrat Rasoul Hospital in Tehran. After LGBP, pain was measured in the following intervals: 24 hours, one week and one month after the operation. Before the operation onset, 2 mg Keflin and 5000 IU subcutaneous heparin were administered as prophylaxis. LGBP was performed using five ports including: one 11 mm port was placed 15-20 cm far from the xiphoid, one 12-mm port in mid-clavicular line at the level of camera port, one 5-mm port in subcostal area in ante-axillary region in the left, another 5-mm port in the right mid-clavicular area and a 5-mm port in sub-xyphoid. All operations were done by the same team. Staple was used for all anastomoses and hand sewn technique to close the staple insertion site. The mesenteric defect was left open and no effort was made to repair it.

Results: The results of this study showed that 99.94 % of the patients had complains of pain in the first 24 hours of post operation, about 60% after one week and 29.5 % still had pain after one month. In addition, left upper quadrant (LUQ) was found to be the most prevalent site for the pain in 53.7% of the patients in the first 24 hours, 59.6% after one week and 16.8% after one month (except for obscure pain) with a significance of < 0.05.

Conclusions: In this study, the authors analyzed the location and disturbance level of pain after LGBP, which could serve as a cornerstone for further researches. The authors suggest that long-term follow-up (for more than a year after operation) should be considered in future studies and also the relationship between the drainage site and pain should be investigated.

Keywords: Abdominal Pain; LGBP Protein; Pacifastacus Leniusculus; Surgical Procedures, Minimally Invasive.

PubMed Disclaimer

References

    1. Santry HP, Gillen DL, Lauderdale DS. Trends in bariatric surgical procedures. Jama. 2005;294(15):1909–17. doi: 10.1001/jama.294.15.1909. - DOI - PubMed
    1. Cho M, Kaidar-Person O, Szomstein S, Rosenthal RJ. Emergency room visits after laparoscopic Roux-en-Y gastric bypass for morbid obesity. Surg Obes Relat Dis. 2008;4(2):104–9. doi: 10.1016/j.soard.2007.05.008. - DOI - PubMed
    1. Kellogg TA, Swan T, Leslie DA, Buchwald H, Ikramuddin S. Patterns of readmission and reoperation within 90 days after Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2009;5(4):416–23. doi: 10.1016/j.soard.2009.01.008. - DOI - PubMed
    1. Foster A, Richards WO, McDowell J, Laws HL, Clements RH. Gastrointestinal symptoms are more intense in morbidly obese patients. Surg Endosc. 2003;17(11):1766–8. doi: 10.1007/s00464-002-8701-5. - DOI - PubMed
    1. Walker SP, Wein P, Ihle BU. Severe folate deficiency masquerading as the syndrome of hemolysis, elevated liver enzymes, and low platelets. Obstet Gynecol. 1997;90(4 Pt 2):655–7. - PubMed

LinkOut - more resources