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Short bowel syndrome after laparoscopic procedures.
Corrigan L McBride1, Dmitry Oleynikov, Debra Sudan
1Department of Surgery, University of Nebraska Medical Center, Omaha, Nebraska, USA.
The American Surgeon
|June 3, 2014
Summary
Short bowel syndrome (SBS) can occur after open or laparoscopic surgery. Laparoscopic procedures show different SBS mechanisms, including volvulus and hypoperfusion, compared to open surgery.
Area of Science:
- Gastroenterology
- Surgical Complications
- Abdominal Surgery
Background:
- Short bowel syndrome (SBS) is a recognized postoperative complication.
- The mechanisms of SBS following laparoscopic surgery are not well understood compared to open procedures.
Purpose of the Study:
- To investigate the potential mechanisms of short bowel syndrome (SBS) after laparoscopic intra-abdominal procedures.
- To compare SBS mechanisms between laparoscopic and open surgical approaches.
Main Methods:
- Retrospective review of 175 adult patients who developed SBS postoperatively.
- Categorization of procedures into open (147 patients) and laparoscopic (28 patients).
- Analysis of causative mechanisms, including adhesive obstruction, volvulus, and ischemia.
Main Results:
- Laparoscopic SBS was most frequent after gastric bypass (46%) and cholecystectomy (32%).
- Volvulus was more common after laparoscopy (46% vs. 18%), while adhesive obstruction predominated in open procedures (57% vs. 22%).
- Ischemia was similar overall, but hypoperfusion was significantly higher in laparoscopic cases (67% vs. 32%). Laparoscopic bariatric procedures frequently involved internal hernias and volvulus.
Conclusions:
- Short bowel syndrome (SBS) is an emerging complication of laparoscopic surgery.
- The mechanisms of intestinal injury in SBS differ significantly between laparoscopic and open procedures.
- Laparoscopic surgery is associated with a higher incidence of volvulus and ischemia due to hypoperfusion, necessitating further investigation.
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