• Skip to primary navigation
  • Skip to main content
  • Skip to primary sidebar
  • Skip to footer

SAGES

Reimagining surgical care for a healthier world

  • Home
    • COVID-19 Annoucements
    • Search
    • SAGES Home
    • SAGES Foundation Home
  • About
    • Who is SAGES?
    • SAGES Mission Statement
    • Advocacy
    • Strategic Plan, 2020-2023
    • Committees
      • Request to Join a SAGES Committee
      • SAGES Board of Governors
      • Officers and Representatives of the Society
      • Committee Chairs and Co-Chairs
      • Full Committee Rosters
      • SAGES Past Presidents
    • Donate to the SAGES Foundation
    • Awards
      • George Berci Award
      • Pioneer in Surgical Endoscopy
      • Excellence In Clinical Care
      • International Ambassador
      • IRCAD Visiting Fellowship
      • Social Justice and Health Equity
      • Excellence in Community Surgery
      • Distinguished Service
      • Early Career Researcher
      • Researcher in Training
      • Jeff Ponsky Master Educator
      • Excellence in Medical Leadership
      • Barbara Berci Memorial Award
      • Brandeis Scholarship
      • Advocacy Summit
      • RAFT Annual Meeting Abstract Contest and Awards
  • Meetings
    • NBT Innovation Weekend
    • SAGES Annual Meeting
      • 2023 Scientific Session Call For Abstracts
      • 2023 Emerging Technology Call For Abstracts
    • CME Claim Form
    • Industry
      • Advertising Opportunities
      • Exhibit Opportunities
      • Sponsorship Opportunities
    • Future Meetings
    • Past Meetings
      • SAGES 2022
      • SAGES 2021
    • Related Meetings Calendar
  • Join SAGES!
    • Membership Benefits
    • Membership Applications
      • Active Membership
      • Affiliate Membership
      • Associate Active Membership
      • Candidate Membership
      • International Membership
      • Medical Student Membership
    • Member News
      • Member Spotlight
      • Give the Gift of SAGES Membership
  • Patients
    • Healthy Sooner – Patient Information for Minimally Invasive Surgery
    • Patient Information Brochures
    • Choosing Wisely – An Initiative of the ABIM Foundation
    • All in the Recovery: Colorectal Cancer Alliance
    • Find a SAGES Member
  • Publications
    • SAGES Stories Podcast
    • SAGES Clinical / Practice / Training Guidelines, Statements, and Standards of Practice
    • Patient Information Brochures
    • TAVAC – Technology and Value Assessments
    • Surgical Endoscopy and Other Journal Information
    • SAGES Manuals
    • SCOPE – The SAGES Newsletter
    • COVID-19 Annoucements
    • Troubleshooting Guides
  • Education
    • OpiVoid.org
    • SAGES.TV Video Library
    • Safe Cholecystectomy Program
      • Safe Cholecystectomy Didactic Modules
    • Masters Program
      • SAGES Facebook Program Collaboratives
      • Acute Care Surgery
      • Bariatric
      • Biliary
      • Colorectal
      • Flexible Endoscopy (upper or lower)
      • Foregut
      • Hernia
      • Robotics
    • Educational Opportunities
    • HPB/Solid Organ Program
    • Courses for Residents
      • Advanced Courses
      • Basic Courses
    • Video Based Assessments (VBA)
    • Robotics Fellows Course
    • MIS Fellows Course
    • Facebook Livestreams
    • Free Webinars For Residents
    • SMART Enhanced Recovery Program
    • SAGES OR SAFETY Video
    • SAGES at Cine-Med
      • SAGES Top 21 MIS Procedures
      • SAGES Pearls
      • SAGES Flexible Endoscopy 101
      • SAGES Tips & Tricks of the Top 21
  • Opportunities
    • NEW-Area of Concentrated Training Seal (ACT)-Advanced Flexible Endoscopy-Coming Soon!
    • SAGES Fellowship Certification for Advanced GI MIS and Comprehensive Flexible Endoscopy
    • Multi-Society Foregut Fellowship Certification
    • SAGES Research Opportunities
    • Fundamentals of Laparoscopic Surgery
    • Fundamentals of Endoscopic Surgery
    • Fundamental Use of Surgical Energy
    • Job Board
    • SAGES Go Global: Global Affairs and Humanitarian Efforts
  • Search
    • Search All SAGES Content
    • Search SAGES Guidelines
    • Search the Video Library
    • Search the Image Library
    • Search the Abstracts Archive
  • Store
    • “Unofficial” Logo Products
  • Log In

Iatrogenic Splenectomy During Bariatric Surgery: Early Postoperative Outcomes

Julietta Chang, MD1, Amin Andalib, MD2, Zhamak Khorgami, MD3, Stacy Brethauer, MD1, Philip Schauer, MD1, Ali Aminian, MD1. 1Cleveland Clinic Foundation, 2McGill University, 3University of Oklahoma

INTRODUCTION: Splenic injury during laparoscopic surgery is rare and occurs with a reported frequency of 0-2.6% and rarely requires splenectomy, which is usually due to uncontrollable hemorrhage. Iatrogenic splenectomy during abdominal procedures such as colorectal and abdominal vascular surgeries have been associated with increased risk of postoperative infectious complications and prolonged hospitalization. We propose that iatrogenic splenectomy at time of primary bariatric surgery is associated with increased postoperative complications.

METHODS AND PROCEDURES: Data were retrieved from the American College of Surgeons – National Surgical Quality Improvement Program (ACS-NSQIP) dataset (2005-2014). Inclusion criteria included: adult patients aged ≥18 years and underwent elective primary bariatric surgical procedures including Roux-en-Y gastric bypass (RYGB), adjustable gastric banding (AGB), sleeve gastrectomy (SG), and duodenal switch (DS) who underwent unplanned splenectomy at time of their initial procedure. Postoperative composite adverse outcome was defined as presence of any of 16 major adverse events. In order to compare postoperative outcomes, this cohort was compared with patients deemed very high risk which was defined as ASA≥3 + BMI ≥50 + Age ≥50 (n=669).

RESULTS: We identified 25 patients (SG n=15, DS n=5, RYGB n=4, and AGB n=1) including 4 men and 21 women from the 2005-2014 ACS-NSQIP dataset who underwent an unplanned splenectomy during their primary bariatric procedure and 669 patients who were defined as very high risk preoperatively (ASA≥3 + BMI ≥50 + Age ≥50) who did not undergo concomitant splenectomy. Median age in the splenectomy group was 47 (range 25-70); median BMI and ASA class were 48 (range 39-91) kg/m2 and 3 (1-3), respectively. Baseline characteristics revealed that the high-risk comparator group to be significantly older with higher BMI and had a higher incidence of preoperative comorbid conditions including diabetes, hypertension, and preoperative dyspnea compared to the simultaneous splenectomy group.

With regards to postoperative outcomes, there was a trend towards more adverse events in the simultaneous splenectomy group compared to the high risk group (20% compared to 9%, P = 0.07); however, there were significantly more thromboembolic complications (12% versus 1%, P < 0.001), as well as a significantly higher incidence of unplanned readmissions (32% vs 8%, P < 0.001).

CONCLUSION: Iatrogenic splenectomy at time of primary bariatric procedure is associated with increased risk of thromboembolic complications and a higher rate of readmission at 30 days postoperatively even in comparison to a group of patients who carry a higher preoperative risk.


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 79374

Program Number: P515

Presentation Session: Poster (Non CME)

Presentation Type: Poster

346

Share this:

  • Twitter
  • Facebook
  • LinkedIn
  • Pinterest
  • WhatsApp
  • Reddit

Related

« Return to SAGES 2017 abstract archive

Our Mission

Innovate, educate and collaborate to improve patient care.

Recently, on SAGES…

Critical View of Safety (CVS) Challenge QR Code

The SAGES Critical View of Safety Challenge – Donate Your Lap Chole Videos!

The Society of American Gastrointestinal and Endoscopic Surgeons is hosting the first Artificial Intelligence Data Challenge conducted by surgeons. The aim of this challenge is to generate a large and diverse dataset of laparoscopic cholecystectomy videos, annotated with respect to the subcomponents of the Critical View of Safety (CVS). Computer scientists from all over the […]

Respuesta de SAGES al Estudio NordICC sobre el beneficio de las colonoscopias de detección

SAGES desea aclarar los resultados del estudio NordICC y colocarlos en contexto de los esfuerzos de varias agencias nacionales para reducir el riesgo de cáncer colorrectal – la segunda causa de muerte por cáncer más frecuente en los Estados Unidos-, mediante la promoción de la detección y tratamiento oportuno de las lesiones.

SAGES Response to NordICC Study Regarding Benefit of Screening Colonoscopies

The NordICC Study recently published in The New England Journal of Medicine and widely reported on by media outlets has raised questions regarding the benefit of screening colonoscopy in lowering the risk of colorectal cancer and cancer-related deaths among otherwise healthy and symptom-free men and women aged 55 to 64. Provocative headlines and commentaries have […]

Contact SAGES

Society of American Gastrointestinal and Endoscopic Surgeons
11300 W. Olympic Blvd Suite 600
Los Angeles, CA 90064 USA
webmaster@sages.org
Tel: (310) 437-0544

Find Us Around the Web!

  • Facebook
  • Twitter
  • YouTube

Important Links

SAGES 2023 Meeting Information

Healthy Sooner: Patient Information

SAGES Guidelines, Statements, & Standards of Practice

SAGES Manuals

 

  • taTME Study Info
  • Foundation
  • SAGES.TV
  • MyCME
  • Educational Activities

Copyright © 2023 Society of American Gastrointestinal and Endoscopic Surgeons