Routine gastrostomy tube placement in gastric bypass patients: impact on length of stay and 30-day readmission rate.

Background: Laparoscopic Roux-en-Y gastric bypass (RYGB) is an effective treatment for morbid obesity. Current average length of hospital stay (LOS) after RYGB is 2-3 days 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.

Methods: 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 6 weeks. A retrospective review of a prospectively collected database was performed for all RYGB patients, noting the outcomes and complications of the procedure.

Results: Average LOS in our patient population was 1.1 days (range, 1-14 days), and 824 (98.3 %) patients were discharged on postoperative day 1. Readmissions within 30 days 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).

Conclusions: 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.