A Single Tertiary Center 10-Year Experience in the Surgical Management of Gastrointestinal Bezoars

Nir Horesh, Danny Rosin, Yael Dreznik, Imri Amiel, Harel Jacoby, Roy Nadler, Mordechai Gutman, Eyal Klang

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Background: Gastrointestinal (GI) bezoars are the most common foreign bodies causing obstruction in the GI tract. They are frequently seen following upper GI tract surgery and surgical intervention is required often. The aim of this study is to describe the surgical management of GI bezoars. Materials and Methods: A retrospective cohort study, including all patients diagnosed with bezoars between May 2008 and May 2017, was conducted. Patient charts were reviewed, and demographics, clinical, surgical, and postoperative data were collected and analyzed. Results: Forty-five patients were included, with a mean age of 62.04 years (Range 18-91). Thirty patients underwent previous surgery (66.6%), most commonly surgical interventions for peptic ulcer disease (22 patients, 73.3%). Obstruction was most common in the ileum (27 patients, 60%). Thirty-nine patients (86.7%) required surgical intervention. Laparoscopy was attempted in 20 patients (51.2%), but conversion to open procedure was required in 11 patients (55%). Postoperative complication rate was 41%. No preoperative factors were found to be correlated with postoperative complications. Postoperative complications were associated with a longer length of stay (P = .006) and a higher readmission rate (P = .04). Patients treated with laparoscopy tended to have a lower BMI (P = .04), less previous surgeries (P = .04), and a bezoar located more proximally (P = .03), however, laparoscopy showed no benefit in complications rate, readmissions, and length of stay. Conclusions: GI bezoars require surgical intervention at high rates. Postoperative complications are common. Completion of an upper GI endoscopy is important and should be performed at an early stage of management.

Original languageEnglish
Pages (from-to)967-971
Number of pages5
JournalJournal of Laparoendoscopic and Advanced Surgical Techniques
Volume28
Issue number8
DOIs
StatePublished - Aug 2018
Externally publishedYes

Keywords

  • bezoar
  • bowel obstruction
  • endoscopy

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