Serum Bicarbonate Changes During Laparoscopic Bariatric Surgery

N/ANot Yet RecruitingNCT07445230

Istinye University85 enrolled

Overview

Pneumoperitoneum during laparoscopic bariatric surgery induces carbon dioxide absorption and may lead to perioperative alterations in acid-base balance. Serum bicarbonate (HCO₃-) plays a central role in metabolic compensation; however, the clinical relevance of perioperative bicarbonate changes remains insufficiently defined. This prospective observational study aims to evaluate the association between pneumoperitoneum duration and perioperative serum bicarbonate change (ΔHCO₃-), and to investigate whether ΔHCO₃- is associated with early discharge readiness at 48 hours (DR-48) following laparoscopic bariatric surgery. Patients undergoing laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass will be enrolled consecutively. No alteration of routine clinical care will occur.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Acid Base Disorder

Interventions

Laparoscopic Bariatric SurgeryOTHER

Standard-of-care laparoscopic bariatric surgery (laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass) performed according to institutional protocols. No experimental intervention is introduced. The study prospectively observes perioperative serum bicarbonate changes and their association with pneumoperitoneum duration and early discharge readiness.

Eligibility

Sex: ALLMin age: 18 Years

Medical Language ↔ Plain English

Inclusion Criteria: * Adults aged ≥18 years * ASA physical status I-III * Scheduled for elective laparoscopic bariatric surgery (laparoscopic sleeve gastrectomy or Roux-en-Y gastric bypass) * Provided written informed consent Exclusion Criteria: * Age \<18 years * ASA physical status IV or higher * Chronic obstructive pulmonary disease (COPD), asthma, or other severe chronic respiratory disease * Known chronic metabolic acidosis or renal failure * Major intraoperative complications (e.g., severe bleeding, conversion to open surgery) * Postoperative reoperation, intensive care requirement, or complications preventing standard recovery evaluation

Outcomes

Primary Outcomes

Perioperative Serum Bicarbonate Change (ΔHCO₃-)

Change in serum bicarbonate (HCO₃-) between the preoperative value (after induction, before pneumoperitoneum) and the postoperative 24-hour value, calculated as: ΔHCO₃- = HCO₃-(24 h postoperative) - HCO₃-(preoperative). The association between pneumoperitoneum duration (minutes) and ΔHCO₃- will be evaluated.

Time frame: From baseline (after induction, before pneumoperitoneum) to 24 hours postoperatively