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Acute gastric volvulus: optimal timing for repair?
Erika Michelin1, Lauren Eberhardt2, Giuseppe Zambito3
1Corewell Health West Minimally Invasive Surgery Fellowship, 1900 Wealthy St SE, Suite 250, Grand Rapids, MI, 49506, USA. michelinerika@gmail.com.
Surgical Endoscopy
|July 22, 2026
Summary
Outpatient repair of gastric volvulus is safe and effective, with optimal timing within 2-3 weeks to prevent re-volvulus. Delayed inpatient repair is recommended when appropriate for gastric volvulus treatment.
Area of Science:
- Gastroenterology
- Surgical Outcomes
- Abdominal Surgery
Background:
- Limited data exists on optimal timing for non-emergent gastric volvulus repair.
- This study compares outcomes of outpatient versus inpatient (urgent/delayed) repair.
Purpose of the Study:
- To evaluate institutional outcomes for different timings of gastric volvulus repair.
- To identify the optimal timing for surgical intervention in resolved obstructing gastric volvulus.
Main Methods:
- Retrospective review of 81 patients undergoing gastric volvulus repair (Nov 2017-Aug 2025).
- Comparison of outpatient, urgent inpatient, and delayed inpatient repair groups.
- Primary outcome: morbidity (Clavien-Dindo). Secondary outcomes: LOS, ICU admission, complications, re-volvulus, readmission.
Main Results:
- Outpatient repair showed shorter operative times and fewer postoperative complications.
- Higher rates of re-volvulus before repair in the outpatient group (29.6%) compared to inpatient groups (2.4%/0%).
- Urgent inpatient repair had more Grade 4a complications, while delayed inpatient repair had more Grade 1 complications.
Conclusions:
- Outpatient repair within 2-3 weeks is optimal to prevent re-volvulus.
- Delayed inpatient repair is a suitable option when indicated for gastric volvulus.
- Timing of repair impacts morbidity and complication rates in gastric volvulus patients.
