Bariatric surgery or in simple terms, the gastric bypass surgery is been performed at a higher rate for severe and dangerous obesity which do not respond to lifestyle measures, dietary changes and medications. As such, it is vital to know the complications and risks involved in going through this procedure before embarking on the same. At the same time, undertaking steps to reduce the risks would also be vital in patient preparation aiming at a possible future bariatric surgery.
There are several approaches in performing this procedure and its discussion would be beyond the scope of this article. But, in brief, many surgeons would undertake the laparoscopic approach rather than the open surgical approach in order to minimize the external incisions as well as to improve the recovery time. Let us now see some of the major risks involved following a gastric bypass surgery with measures that can be undertaken to reduce these risks as much as possible.
Bleeding
Bleeding is a known complication of many types of surgery and it can take place soon after the surgery or else after several days from the surgery. Depending on the severity of the bleeding, the consequences may vary and in most instances, the bleeding may go unnoticed. But, monitoring the vital signs and performing a post surgical hemoglobin level would assist in detecting such bleeds early and would allow the clinicians to seal off the oozing area before major complications arise.
Leakage through anastomosis
Bariatric surgery involves the linking up of parts of the stomach with distal portions of the intestine and this would involve anastomosis. Stapling devices are used in preparing these anastamosis connections and in certain instances, these linkages can give away. Such leakage can lead to spillage of intestinal content to the abdominal cavity and therefore the development of serious and sometimes life threatening infections such as peritonitis and sepsis. Thus, patients need to be monitored for development of fever, shortness of breath, severe abdominal pain, abdominal distension…etc to detect such leakage early.
Pulmonary embolism
In certain instances, some patients are susceptible for the development of blood clots in the lower limbs which can dislodge and travel towards the lung circulation. When the clots disrupt the blood flow in the lungs, these areas would be deprived of circulation and will lead to dysfunction and collapse. The condition would be fatal unless it is prevented in most instances and early mobilization and the use of blood thinning agents in susceptible patients would support in preventing these complications.
Strictures and bowel obstruction
Excessive formation of scar tissues at the site of surgery as well as kinking at various places of the intestine can give rise to narrowing or blockage of the intestine and would manifest as intolerance of ingested foods and fluids through vomiting, abdominal distension and pain. These complications should be corrected as soon as possible to avoid further complications.
Nutritional deficiencies
In certain instances, gastric bypass surgery would lead to deprivation of certain nutrients and therefore they would require supplements as instructed by the clinicians and the dietitian.
Apart from the above risks and complications, these patients are also susceptible to develop increase incidence of gallstones, ulcers as well as other infections and close follow-up would be vital to avoid such manifestations.
