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      Assessing Bleeding Risk in Bariatric Surgeries: A Retrospective Analysis Study

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          Abstract

          Objective: To determine the factors that influence bleeding during the course of bariatric surgeries. Background: Bariatric surgery is safe with a low percentage of complications compared with other abdominal surgeries. Bleeding is one of the most common complications in surgery for obesity that has the risk of being catastrophic. Methods: The study includes 8,544 cases that underwent bariatric surgery from January 2013 to March 2016 retrospectively, in 4 private institutions. Multiple demographic data were collected: patient characteristics, diseases, medications, surgery type, operative technique, devices, surgeon’s skill, and volume. Results: Bleeding was the most frequent complication that occurred in 122 (1.3%) patients. The Gastric bypass had the highest rate of bleeding (3.05%) of which, 20% were intraoperative bleeding and 80% postoperatively (intra-abdominal in 75%, and intra-luminal in 5%). Simultaneous surgeries, revisional surgeries, stratification of body mass index, stapler line reinforcement, and hospital volume did not affect bleeding occurrence. The determining factors for bleeding were hypertension, chronic lung disease, age >45 years, arrhythmia, and surgeon’s skills. Conclusion: Bleeding after bariatric surgery has a low occurrence. The factors that influence the occurrence of perioperative bleeding in bariatric surgery are: hypertension, chronic lung disease, age >45 years, arrhythmia, and surgeon’s skills.

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          Author and article information

          Journal
          DDI
          Dig Dis
          10.1159/issn.0257-2753
          Digestive Diseases
          S. Karger AG
          0257-2753
          1421-9875
          2020
          November 2020
          13 February 2020
          : 38
          : 6
          : 449-457
          Affiliations
          [_a] aDepartment of Surgery, Assuta Medical Center, Tel Aviv, Israel
          [_b] bFaculty of Medicine, Ben Gurion University, Be’ar Sheva, Israel
          [_c] cDepartment of Industrial Engineering and Management, Ariel University, Ariel, Israel
          [_d] dAssia Medical Group, Assuta Medical Center, Tel Aviv, Israel
          [_e] eAssuta Health Services Research Institute, Assuta Medical Center, Tel Aviv, Israel
          [_f] fDeputy Hospital Manager, Assuta Medical Center, Tel Aviv, Israel
          Author notes
          *Sergio Susmallian, MD, Department of Surgery, Assuta Medical Center, 20 Habarzel Street, IL–69710, Tel Aviv (Israel), sergio9@bezeqint.net
          Article
          506456 Dig Dis 2020;38:449–457
          10.1159/000506456
          32053819
          6af70619-4d5f-4806-adf3-66330f7284d1
          © 2020 S. Karger AG, Basel

          Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher. Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug. Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.

          History
          : 15 November 2019
          : 12 February 2020
          Page count
          Figures: 3, Tables: 5, Pages: 9
          Categories
          Stomach and Duodenum: Research Article

          Oncology & Radiotherapy,Gastroenterology & Hepatology,Surgery,Nutrition & Dietetics,Internal medicine
          Bleeding,Bariatric surgery,Risk factor,Obesity

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