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
. 2023 Aug;33(8):2317-2323.
doi: 10.1007/s11695-023-06697-x. Epub 2023 Jun 22.

Evaluation of Postoperative Care Protocol for Roux-en-Y Gastric Bypass Patients with Same-Day Discharge

Suzanne C Kleipool  1 , Pim W J van Rutte  2 , Laurens D Eeftinck Schattenkerk  2 , H Jaap Bonjer  3 , Hendrik A Marsman  2 , Steve M M de Castro  2 , Ruben N van Veen  2
Affiliations

Evaluation of Postoperative Care Protocol for Roux-en-Y Gastric Bypass Patients with Same-Day Discharge

Suzanne C Kleipool et al. Obes Surg. 2023 Aug.

Abstract

Introduction: Same-day discharge (SDD) after bariatric surgery is increasingly being performed and is safe with careful patient selection. However, detecting early complications during the first postoperative days can be challenging. We developed a postoperative care protocol for these patients and aimed to evaluate its effectiveness in detecting complications and monitoring patient recovery.

Methods: A single-center retrospective observational study was conducted with patients with who underwent Roux-en-Y Gastric Bypass (RYGB) with successful SDD. The study evaluated the effectiveness of the safety net that included simple remote monitoring with a pulsoximeter and thermometer, a phone consultation on postoperative day (POD) 1, and a physical consultation on POD 2-4. Furthermore, an analysis was performed on various factors including pain scores, painkiller usage, and incidences of nausea and vomiting on POD 1.

Results: In this study, 373 consecutive patients were included, of whom 19 (5.1%) were readmitted until POD 4. Among these, 12 patients (3.2%) reached out to the hospital themselves, while 7 (1.9%) were readmitted after phone or physical consultations. Ten of the readmitted patients had tachycardia. On POD 1, the mean numeric rating scale was 4 ± 2, and 96.6% of the patients used acetaminophen, 35.5% used naproxen, and 9.7% used oxynorm. Of the patients, 13.9% experienced nausea and 6.7% reported vomiting.

Conclusion: A postoperative care protocol for SDD after RYGB, comprising simple remote monitoring along with a phone consultation on POD 1 and a physical checkup on POD 2-4, was effective in monitoring patient recovery and detecting all early complications.

Keywords: Monitoring; Postoperative care; Roux-en-Y gastric bypass; Safety net; Same-day discharge.

PubMed Disclaimer

References

    1. WHO. World Obesity day 2022 – accelerating action to stop obesity. 2022. Available from: https://www.who.int/news/item/04-03-2022-world-obesity-day-2022-accelera... .
    1. Buchwald H, Estok R, Fahrbach K, et al. Trends in mortality in bariatric surgery: a systematic review and meta-analysis. Surgery. 2007;142(4):621–32; discussion 632-625. https://doi.org/10.1016/j.surg.2007.07.018 . - DOI - PubMed
    1. Zellmer JD, Mathiason MA, Kallies KJ, et al. Is laparoscopic sleeve gastrectomy a lower risk bariatric procedure compared with laparoscopic Roux-en-Y gastric bypass? A meta-analysis. Am J Surg. 2014;208(6):903–10; discussion 909-910. https://doi.org/10.1016/j.amjsurg.2014.08.002 . - DOI - PubMed
    1. Stenberg E, Dos Reis Falcao LF, O'Kane M, et al. Guidelines for perioperative care in bariatric surgery: enhanced recovery after surgery (eras) society recommendations: a 2021 update. World J Surg. 2022;46(4):729–51. https://doi.org/10.1007/s00268-021-06394-9 . - DOI - PubMed - PMC
    1. Zhou J, Du R, Wang L, et al. The application of enhanced recovery after surgery (ERAS) for patients undergoing bariatric surgery: a systematic review and meta-analysis. Obes Surg. 2021;31(3):1321–31. https://doi.org/10.1007/s11695-020-05209-5 . - DOI - PubMed

LinkOut - more resources