Patients presenting with acute abdominal pain that occurs after months or years following bariatric surgery may present for assessment and management in the local emergency units. Due to the large variety of surgical bariatric techniques, emergency surgeons have to be aware of the main functional outcomes and long-term surgical complications following the most performed bariatric surgical procedures. The purpose of these evidence-based guidelines is to present a consensus position from members of the WSES in collaboration with IFSO bariatric experienced surgeons, on the management of acute abdomen after bariatric surgery focusing on long-term complications in patients who have undergone laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. A working group of experienced general, acute care, and bariatric surgeons was created to carry out a systematic review of the literature following the Preferred Reporting Items for Systematic Review and Meta-analysis Protocols (PRISMA-P) and to answer the PICO questions formulated after the Operative management in bariatric acute abdomen survey. The literature search was limited to late/long-term complications following laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass. The acute abdomen after bariatric surgery is a common cause of admission in emergency departments. Knowledge of the most common late/long-term complications (> 4 weeks after surgical procedure) following sleeve gastrectomy and Roux-en-Y gastric bypass and their anatomy leads to a focused management in the emergency setting with good outcomes and decreased morbidity and mortality rates. A close collaboration between emergency surgeons, radiologists, endoscopists, and anesthesiologists is mandatory in the management of this group of patients in the emergency setting.

中文翻译：

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紧急情况下减肥手术后急腹症的手术治疗：OBA 指南

减肥手术后数月或数年后出现急性腹痛的患者可能会到当地急诊室接受评估和处理。由于手术减肥技术种类繁多，急诊外科医生必须了解大多数减肥手术后的主要功能结果和长期手术并发症。这些循证指南的目的是提出 WSES 成员与 IFSO 减肥经验丰富的外科医生合作的共识立场，关于减肥手术后急腹症的管理，重点关注接受腹腔镜袖状胃切除术的患者的长期并发症和腹腔镜 Roux-en-Y 胃旁路术。一个由经验丰富的普通急症护理人员组成的工作组，和减肥外科医生的创建是为了按照系统评价和元分析协议 (PRISMA-P) 的首选报告项目对文献进行系统评价，并回答减肥急腹症手术管理调查后制定的 PICO 问题。文献检索仅限于腹腔镜袖状胃切除术和腹腔镜 Roux-en-Y 胃旁路手术后的晚期/长期并发症。减肥手术后的急腹症是急诊科住院的常见原因。了解袖状胃切除术和 Roux-en-Y 胃旁路手术后最常见的晚期/长期并发症（手术后 > 4 周）及其解剖结构，有助于在急诊环境中进行重点管理，取得良好效果并降低发病率和死亡率费率。