Intussusception After Roux-en-Y Gastric Bypass for the Treatment of Severe Obesity: a Systematic Review and Meta-Analysis.

INTRODUCTION: Roux-en-Y gastric bypass (RYGB) is an effective bariatric procedure but may be complicated by rare yet serious adverse events, including jejunojejunal intussusception (JJI). This systematic review and meta-analysis aimed to evaluate the incidence, clinical presentation, diagnostic modalities, management strategies, and recurrence of JJI following RYGB to inform clinical practice. METHODS: A systematic review was conducted in accordance with PRISMA guidelines. Studies reporting JJI after RYGB were identified and assessed for incidence, recurrence, and clinical outcomes. Study quality was evaluated using the Newcastle–Ottawa Scale. Pooled analyses were performed using Comprehensive Meta-Analysis software. Heterogeneity was assessed using Cochran’s Q and the I² statistic. Meta-regression analyses explored associations between clinical variables and recurrence risk. RESULTS: Nine retrospective studies including 223 patients were analyzed, revealing 0.7% incidence of intussusception post-RYGB, mainly in females (91.9%), with an average age of 39.6 years, occurring on average 48.3 months postoperatively. Most were diagnosed by CT (64%) and treated surgically by laparoscopic resection (47.6%) or reduction (25.7%). Recurrence of JJI was reported in 15.9% of patients, with a mean time to recurrence of 22.9 months. Case reports (n = 112) showed similar patterns but with greater weight loss and longer onset (72.2 months). Among pregnant patients (n = 19), most underwent open surgery; outcomes were generally favorable, though 26.3% had preterm labor and one fetal death. Meta-regression found no significant recurrence predictors; longer time to onset trended towards higher risk (p = 0.08). CONCLUSIONS: JJI is a rare, late complication of RYGB with a nonspecific presentation. CT remains the diagnostic standard; surgery, particularly laparoscopic resection, is the cornerstone of treatment overall.