American Society for Metabolic and Bariatric Surgery: postoperative care pathway guidelines for Roux-en-Y gastric bypass

Background: Clinical care pathways and guidelines help guide and provide structure to clinicians and providers to improve healthcare delivery and quality. The Quality Improvement and Patient Safety (QIPS) Committee of the American Society for Metabolic and Bariatric Surgery (ASMBS) has previously published care pathways for the performance of laparoscopic sleeve gastrectomy (LSG), preoperative care of patients undergoing Roux-en-Y gastric bypass (RYGB), and most recently, intraoperative care of patients undergoing RYGB. Objectives: This current RYGB care pathway guideline was created to address postoperative care guidance. Setting: Academic Health Center. Methods: For this systematic review, PubMed queries were performed from January 1979 to December 2019. Follow-up queries were performed from January 2020 to July 2024. Peer-reviewed publications were reviewed according to the level of evidence (LoE) regarding specific key questions developed by the QIPS Committee and working group for this pathway. Results: Evidence-based recommendations are made for the postoperative care of patients undergoing RYGB, including recommendations for early postoperative care, postoperative medication management, and long-term postoperative surveillance. Conclusions: This document may provide a structure to providers based on current evidence for the postoperative care of patients with overweight or obesity undergoing RYGB.