Routine Gastrostomy Tube Placement in Gastric Bypass Patients: Impact on Length of Stay and 30-Day Readmission Rate

Abstract

Laparoscopic Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity. Current average length of hospital stay (LOS) after RYGB is 2-3days and 30-day readmission rate is 8-13%. The aim of our study is to evaluate the effect of routine gastrostomy tube placement in perioperative outcomes of RYGB patients. Between January 2008 and December 2010, a total of 840 patients underwent RYGB at our institution. All RYGB patients had gastrostomy tube placed, which was kept for 6weeks. A retrospective review of a prospectively collected database was performed for all RYGB patients, noting the outcomes and complications of the procedure. Average LOS in our patient population was 1.1days (range, 1-14days), and 824 (98.3%) patients were discharged on postoperative day1. Readmissions within 30days after the index RYGB was observed in 31 (3.7%) patients. Reasons included abdominal pain (n = 14), nausea/vomiting (n = 6), gastrostomy tube-related complications (n = 5), chest pain (n = 3), allergic reaction (n = 1), urinary tract infection (n = 1), and dehydration (n = 1). Of these readmitted patients, nine (1.1%) patients required reoperations due to small bowel obstruction (n = 5), perforated anastomotic ulcer (n = 1), anastomotic leak (n = 1), subphrenic abscess (n = 1), and appendicitis (n = 1). Routine gastrostomy tube placement in the gastric remnant at the time of RYGB seems to have contributed to our short LOS and low 30-day readmission rate.