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Article Dans Une Revue Surgery for Obesity and Related Diseases Année : 2020

Management of surgical complications of previous bariatric surgery in pregnant women. A systematic review from the BARIA-MAT Study Group

Muriel Coupaye
Philippe Deruelle
  • Fonction : Auteur
Geraldine Gascoin
  • Fonction : Auteur
Daniela Calabrese
  • Fonction : Auteur
Emmanuel Cosson
Guillaume Ducarme
  • Fonction : Auteur
Benedicte Lelievre
  • Fonction : Auteur
Laurent Mandelbrot
  • Fonction : Auteur
  • PersonId : 1008610
Didier Quilhot
  • Fonction : Auteur
Patrick Ritz
  • Fonction : Auteur
  • PersonId : 837931
Geoffroy Robin
  • Fonction : Auteur
Agnès Sallé
  • Fonction : Auteur
Jacky Nizard
  • Fonction : Auteur
Virginie Castera
  • Fonction : Auteur
Regis Coutant
  • Fonction : Auteur
Thierry Dupré
  • Fonction : Auteur
  • PersonId : 889681
Hubert Johanet
  • Fonction : Auteur
Marie Pigeyre
  • Fonction : Auteur
Brigitte Rochereau
  • Fonction : Auteur
Véronique Taillard
  • Fonction : Auteur
Claudine Canale
  • Fonction : Auteur
Anne-Sophie Joly
  • Fonction : Auteur

Résumé

Considering the large and increasing population of women of childbearing age with history of bariatric surgery, surgical complications of bariatric surgery during pregnancy may become more frequent in the future. The aim of this study was to analyze the clinical presentation, diagnostic procedures, and treatment of surgical complications of bariatric surgery during pregnancies. A systematic literature search was performed in accordance with the PRISMA (preferred reporting items for systematic review and meta-analysis) guidelines to identify all studies published up to and including December 2018 that included women with previous bariatric surgery undergoing emergency surgery during pregnancy. Sixty-eight studies were selected, including 120 women with previous bariatric surgery undergoing emergency surgery during pregnancy. Fifty cases were reported as case reports and 70 in case series. Included patients had previous history of Roux-en-Y gastric bypass (n = 99), laparoscopic adjustable gastric banding (n = 17), Scopinaro procedure (n = 2), vertical banded gastroplasty (n = 1), or one-anastomosis gastric bypass (n = 1). Final diagnosis in 50 case reports was internal hernia in 26 cases, bowel intussusception in 10, intestinal obstruction in 2, laparoscopic adjustable gastric banding slippage in 3, bowel volvulus in 3, gastric or jejunal perforation in 2, and other complications in 4 cases. Maternal and fetal death occurred in 3 (2.5%) and 9 cases (7.5%), respectively. In the case series, the majority of women were operated for internal hernia and laparoscopic adjustable gastric banding slippage. Surgical complications of previous bariatric surgery during pregnancy have potentially severe outcomes. Availability of multidisciplinary expertise, including bariatric/digestive surgeons, and education of healthcare providers and women on clinical signs that require urgent surgical examination are recommended in this setting. Prompt diagnosis is fundamental and based on clinical and laboratory findings and on radiologic examinations if needed, including computed tomography scan or magnetic resonance if available. Rapid surgical exploration is mandatory in case of high clinical and/or radiologic suspicion. (C) 2019 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
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Dates et versions

hal-03169644 , version 1 (21-07-2022)

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Paternité - Pas d'utilisation commerciale

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Cecile Ciangura, Tarek Debs, Muriel Coupaye, Philippe Deruelle, Geraldine Gascoin, et al.. Management of surgical complications of previous bariatric surgery in pregnant women. A systematic review from the BARIA-MAT Study Group. Surgery for Obesity and Related Diseases, 2020, 16 (2), pp.312-331. ⟨10.1016/j.soard.2019.10.022⟩. ⟨hal-03169644⟩
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