Introduced by Rutledge in 1997, MGB has now become a commonly performed bariatric operation in Europe and in the Asia/Pacific region. Early complications are defined as complications occurring within the first 30 postoperative days. In our experience of 2678 patients, 3.1% suffered from early complications. Among them, 74/2251 patients (3.2%) developed an early complication following a primary MGB, while 10/427 patients (2.3%) presented a complication following revision to an MGB.
Four categories of major early complications can be distinguished: bleeding, leaks, small bowel perforation, and anastomotic stenosis. Bleeding is the most common complication, with a total rate of 1.71%, and can be divided into intra-abdominal and endoluminal bleeding. Leaks are the second most common complication, and they include anastomotic leaks and gastric pouch leaks. The complication rate in our series is 0.18% for leaks on the anastomotic suture-line and 0.26% for leaks of the gastric pouch. Small bowel perforation is the third complication in terms of rate (0.22%). Similar to RYGB, perforation in MGB seems to be strongly associated with marginal ulcer. Anastomotic stenosis has a rate of 0.18% and is probably due to anastomotic tension, ischemia and subclinical leaks.
Other complications reported are abdominal wall hernias (rate 0.14%), gastroparesis (0.03%), abdominal abscess (0.07%), and wound infection (0.03%).
Comparing the results with other large series, MGB technique has demonstrated a lower rate of early complications compared to both LSG and RYGB. Moreover, the safety and efficacy of MGB make it a valid option for technically difficult super-obese patients.
MGB Early complications Bleeding Leaks Small bowel perforation Anastomotic stenosis
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