Unexplained abdominal pain in morbidly obese patients after bariatric surgery

Annouk S. Pierik*, Usha K. Coblijn, Christel A.L. de Raaff, R. N. van Veen, Willem F. van Tets, Bart A. van Wagensveld

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background There is an overall complication rate of 6.3%–10% after bariatric surgery. After ruling out anatomic/physical causes, there is a substantial group of patients who develop unexplained postsurgical abdominal pain. Objectives To inventory the prevalence of unexplained abdominal pain after laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy and to determine predictive factors for unexplained abdominal pain. Setting Obesity Center Amsterdam, Amsterdam, the Netherlands. Methods A retrospective study in a prospective database was performed. Baseline characteristics and postoperative course were evaluated. Results A total of 1788 patients underwent laparoscopic Roux-en-Y gastric bypass or laparoscopic sleeve gastrectomy between November 2007 and April 2015. The average follow-up consisted of 33.5 months, without loss to follow-up. Abdominal pain was presented in 387 patients (21.6%). The study population consisted of 337 women (87.1%) and 50 men (12.9%); the mean age was 43.3 years (standard deviation 10.1) and the median preoperative body mass index was 43.7 kg/m². An explanation for abdominal pain was found in 246 of 387 patients (63.6%), whereas no explanation was found in 133 patients (34.4%). Revisional surgery was a significant predictor for unexplained pain (odds ratio 1.7; confidence interval 1.0–2.8; P = 0.037). Conclusion A total of 133 patients (7.4%) experienced unexplained abdominal pain after laparoscopic bariatric surgery. Revisional surgery was found to be a significant predictive factor for this outcome. Present study results suggest that postoperative unexplained abdominal pain is a significant morbidity and should be part of the informed consent. More research is needed regarding further diagnosis and management and treatment.

Original languageEnglish
Pages (from-to)1743-1751
Number of pages9
JournalSurgery for Obesity and Related Diseases
Volume13
Issue number10
DOIs
Publication statusPublished - 1 Oct 2017

Cite this

Pierik, A. S., Coblijn, U. K., de Raaff, C. A. L., van Veen, R. N., van Tets, W. F., & van Wagensveld, B. A. (2017). Unexplained abdominal pain in morbidly obese patients after bariatric surgery. Surgery for Obesity and Related Diseases, 13(10), 1743-1751. https://doi.org/10.1016/j.soard.2017.05.027