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As with any surgery, there are potential risks to consider.
Gastric bypass is a major surgical procedure because of its
manipulation of the stomach and intestines, their proximity
with vital organs, use of general anesthesia, and because
it is usually performed on unhealthy patients.
Although death and major
surgical complications are infrequent, some problems require
additional surgery or hospitalization. The most commonly occurring
complications associated with bariatric surgery are as follows:
-
Leak - seepage of
digestive fluid at any of the staple or suture lines in
the abdomen
-
Bowel obstruction
- blockage in the small intestine passageways
-
Pulmonary embolus
- a blood clot which forms in the pelvis or lower extremity,
breaks loose and travels to the lungs
-
Other pulmonary problems
- inadequate breathing or pneumonia
*Importantly, pulmonary complications frequently occur
in patients who smoke and therefore are avoidable. Most
surgeons will not operate on anyone who is not smoke-free
at least 8 weeks prior to surgery.
-
Wound infection -
Thick layers of abdominal wall fat tissue are less able
to fight infection from bacteria that may enter through
incisions.
-
Splenectomy - Since
the spleen is situated closely to the stomach, uncontrollable
bleeding from adhesions or trauma may necessitate its
removal.
-
Incisional hernia
- inadequate wound healing may need later surgical repair.
-
Stricture/esophagitis
- irritation or narrowing in the gastric pouch or its
outlet. If this occurs, typically six weeks after surgery,
a gastroenterologist may need to use an instrument called
an endoscope to stretch the stricture.
-
Gallstones - symptomatic
gallbladder disease may require its removal
-
Vitamin/mineral deficiency
- inadequate amounts of iron, calcium, or B12 may be corrected
by oral supplementation or injections.
- Pancreatitis
- infection of the pancreas.
Other concerns:
- Hair loss - inadequate
amounts of protein in the post-surgical diet can contribute
to temporary hair loss.
- Complications with pregnancy
and childbirth - women are strictly advised to
use effective birth control* methods for at least 12 months
after gastric bypass to avoid problems with fetal development.
In patients who have had lap-banding, the band must be
removed before conception.
*Obesity is often associated with infertility. 1
Women who’ve had trouble conceiving prior to surgery,
may in fact, become fertile after significant weight loss.
- Excessive skin - some
patients may develop irritations or other problems related
to saggy, redundant skin after dramatic weight loss. This
may require surgical removal, commonly from regions of
the abdomen, upper arms, breasts, and thighs.
- Nausea/vomiting -
food intolerances may occur throughout different phases
of the gastric bypass diet
- Lactose intolerance
- unpleasant symptoms like diarrhea, cramping, and abdominal
discomfort may develop after dairy consumption
- Weight regain - Typically
a year or so after surgery, once appetite returns and
metabolism normalizes, patients who do not adhere to the
guidelines recommended for proper nutrition, regular exercise,
and behavior change are at risk for weight regain
1. Linne. Obes Rev 2004 Aug;5(3):137-43.
Norman, et. al. Hum Reprod Update 2004 May-Jun;10(3):267-80
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