Diabetes and Hypertension: Is There Any Linkage to the Hemorrhage After Bariatric Surgery? Publisher



Mirhashemi S¹ ; Mirzaian E² ; Gachkar L³ ; Ebrahimi F⁴ ; Yeganeh FE¹ Show Affiliations
Source: World Journal of Laparoscopic Surgery Published:2022

Abstract

Background: Bleeding after bariatric surgery is one of the most common early postoperative complications that can cause morbidity or even mortality. Therefore, in this study, we investigated the relationship between demographic features and postoperative hemorrhage rate. Materials and methods: We reviewed the patients’ database who underwent laparoscopic bariatric surgery [sleeve gastrectomy (SG) and one anastomosis gastric bypass (OAGB)] from 2018 to 2020 in Loghman Hakim Hospital, Tehran, Iran. The patients’ demographic features such as age, sex, weight, BMI, and history of diabetes mellitus and hypertension were accessed in all patients. Patients who required postoperative blood transfusion were then identified. Red blood cell transfusion or the need for reoperation to control bleeding was considered as significant acute bleeding after surgery. The Hb cut-off for red blood cell (RBC) transfusion was 7 gm/dL. The rate of bleeding was determined. By comparing the two groups (with and without the need for blood transfusion) by Chi-square test and independent t-test, the relationship between demographic features and postoperative bleeding was investigated. Results: In total, 1481 morbidly obese patients (257 men and 1224 women) who underwent bariatric surgery SG and OAGB were studied. Twenty patients (0.13%) suffered a postoperative hemorrhage. In SG, 17 patients (1.3%), and in OAGB, 3 patients (4.3%) required blood transfusion. The difference in diabetes (p <0.03) and hypertension (p <0.048) in the two groups (with and without the need for blood transfusion) was statistically significant. Only two patients (10%) who underwent SG were taken to the operating room at the surgeon’s discretion to control the bleeding (both had a blood transfusion before reoperation). Diabetes (35%) and hypertension (25.7%) were significantly more common in postoperative bled patients. Conclusion: Despite all measures to reduce hemorrhage during and after bariatric surgery, bleeding is still one of the most common early postoperative complications after bariatric surgery. Therefore, recognizing the risk factors for bleeding is still important. In this study, an association was observed between hypertension and diabetes with postoperative bleeds. © The Author(s).