Complications in Bariatric Surgery

Bariatric surgery can lead to various complications, including nutritional deficiencies, anastomotic and staple line leaks, and specific complications like gastric fistula, gastric staple line disruption, gastro-jejunal leak, reflux, and weight loss failure. This text provides an overview of these complications, written by experts in the field, and includes evidence-based medicine and expert opinion on management. It will be a valuable resource for general surgeons and bariatric specialists.

Format: Hardback
Length: 225 pages
Publication date: 11 May 2018
Publisher: Springer International Publishing AG

Bariatric surgery, also known as weight loss surgery, is a procedure that involves surgically reducing the size of the stomach to limit food intake and promote weight loss. While bariatric surgery can be a highly effective tool for achieving long-term weight loss and improving health, it is not without its risks and complications. In this article, we will explore the various complications that can occur following bariatric surgery, including both immediate and long-term complications.

Nutritional Deficiencies: One of the most common complications following bariatric surgery is nutritional deficiencies. This can occur due to the reduced size of the stomach, which limits the amount of food that can be absorbed and digested. Nutritional deficiencies can lead to a range of health problems, including anemia, vitamin deficiencies, and bone loss.

Roux en Y Gastric Bypass (RYGB): RYGB is a type of bariatric surgery that involves creating a small pouch in the upper part of the stomach and connecting it to the small intestine. This procedure can lead to nutritional deficiencies, particularly in vitamins B12 and iron.

Pancreatico-Biliary Diversion: Pancreatico-biliary diversion is a type of bariatric surgery that involves redirecting the flow of bile and pancreatic juices from the digestive system to the small intestine. This procedure can also lead to nutritional deficiencies, particularly in vitamins B12 and iron.

Correction of Nutritional Deficiencies: To correct nutritional deficiencies following bariatric surgery, medical intervention is often necessary. This may include vitamin supplements, dietary changes, and in some cases, intravenous nutrition. In some cases, surgical revision or reversal may be necessary to address nutritional deficiencies.

Work-Up of Abdominal Pain: Abdominal pain is a common complication following bariatric surgery, particularly in the early postoperative period. The work-up of abdominal pain following bariatric surgery should include appropriate imaging and threshold for operative intervention. Imaging modalities such as ultrasound, CT scan, or MRI can help identify the cause of abdominal pain and guide operative intervention.

Operative Management of Anastomotic and Staple Line Leaks: Anastomotic and staple line leaks are surgical emergencies that can occur following bariatric surgery. These leaks can be life-threatening and require immediate operative management. The operative management of anastomotic and staple line leaks should include source control and stabilization. This may involve surgical revision, drainage of fluid collections, or the placement of surgical drains.

Specific Complications: Bariatric surgery can lead to a range of specific complications, depending on the type of surgery performed. These complications include gastric fistula, gastric staple line disruption following vertical sleeve gastrectomy (VSG), gastro-jejunal leak following RYGB, reflux following bariatric surgery, and failure of weight loss following bariatric surgery.

Gastric Fistula: Gastric fistula is a rare but serious complication that can occur following bariatric surgery. It occurs when the stomach wall separates from the small intestine, allowing food and digestive juices to leak into the abdominal cavity. Gastric fistula can lead to severe bleeding, infection, and malnutrition.

Gastric Staple Line Disruption Following VSG: Gastric staple line disruption following VSG is a common complication that can occur in the early postoperative period. It occurs when the staple line that connects the stomach to the small intestine becomes loose or breaks, allowing food and digestive juices to leak into the abdominal cavity. Gastric staple line disruption can lead to severe bleeding, infection, and malnutrition.

Gastro-Jejunal Leak Following RYGB: Gastro-jejunal leak following RYGB is a rare but serious complication that can occur in the early postoperative period. It occurs when the junction between the stomach and the small intestine becomes leaky, allowing food and digestive juices to leak into the abdominal cavity. Gastro-jejunal leak can lead to severe bleeding, infection, and malnutrition.

Reflux Following Bariatric Surgery: Reflux following bariatric surgery is a common complication that can occur in the early postoperative period. It occurs when stomach contents leak back up into the esophagus, causing heartburn, chest pain, and difficulty swallowing. Reflux can be managed with lifestyle changes and medication, but in some cases, surgical revision may be necessary.

Failure of Weight Loss Following Bariatric Surgery: Failure of weight loss following bariatric surgery is a common complication that can occur in the long-term. It occurs when patients fail to maintain their weight loss or experience a significant regain of weight. Failure of weight loss can be attributed to a range of factors, including poor dietary habits, lack of exercise, and psychological issues.

Management of Bariatric Complications: The management of bariatric complications requires a multidisciplinary approach. This may include a team of surgeons, dietitians, and psychologists who work together to provide comprehensive care to patients. In some cases, surgical revision or reversal may be necessary to address complications.

Conclusion: Bariatric surgery can be a highly effective tool for achieving long-term weight loss and improving health, but it is not without its risks and complications. Nutritional deficiencies, anastomotic and staple line leaks, specific complications, and failure of weight loss following bariatric surgery are all common complications that can occur following bariatric surgery. It is important for patients to be informed about these risks and complications before undergoing bariatric surgery and to work closely with their healthcare team to manage any complications that may occur.

Weight: 480g
Dimension: 161 x 243 x 18 (mm)
ISBN-13: 9783319758404
Edition number: 1st ed. 2018