As the most common weight loss surgery for obese patients, gastric bypass can provide dramatic weight loss and its attendant health benefits. In this procedure, the surgeon staples off the upper stomach and re-routes the small intestine to the newly created pouch, bypassing the section of small intestine that attaches to the bottom of the stomach. The Mayo Clinic claims that gastric bypass surgery is safer than other weight loss procedures, but it still has its share of complications.
Types
Complications after gastric bypass can arise from the surgery itself or the changes in diet that must accompany it. Risks directly related to the surgical procedure include infection and blood clots, leaky staples, and narrowing of the opening to the intestines. Patients can suffer hernias at the site of the surgical incision. Dietary changes mandated after the surgery can cause a multitude of problems, ranging from nausea to malnutrition and depression.
Time Frame
Immediately after the surgery, complications include post-surgical infection of the incision and opportunistic infections like pneumonia. Blood clots are a danger, especially in patients with limited mobility; these can be life-threatening if they travel to the lungs and cause a pulmonary embolism. In the first three to six months after surgery, patients experience rapid weight loss that can be accompanied by hair loss, body aches and problems with gall bladder function. Patients who do not faithfully stick to the diet, and even some who do, can suffer long-term effects from poor nutrition, including increased risk of kidney stones, anemia from a lack of vitamin B12, or osteoporosis from a lack of calcium.
Frequency
The most common post-surgical complication, infection of the incision, occurs in about 6.6 percent of patients with a large incision, according to an analysis of data from several studies compiled by Dr. Yale Podnos and colleagues in the September 2003 issue of "Archives of Surgery." The most common later complication, hernia at the site of the incision, occurred in about 8.6 percent of patients with a large incision.
Differences
Dr. Podnos' study compared complications after gastric bypass using a traditional large incision compared to using a laparoscopic technique. Not surprisingly, Dr. Podnos reported that complications like wound infection and hernia were significantly more frequent after a large incision. However, bleeding in the gastrointestinal tract, obstruction of the bowels and narrowing of the intestinal opening (stomal stenosis) were significantly more frequent after the laparoscopic procedure.
Solutions
Patients can minimize their risk for complications by being active as soon as possible after the surgery and rigidly adhering to the post-surgical diet. For cases where the stomach staples leak, antibiotics and time might solve the problem; in other serious cases, the patient might need emergency surgery. For cases where the intestinal opening narrows, a doctor might be able to widen the opening by running a tube through it in an outpatient procedure, or another corrective surgery might be needed.
References
- Mayo Clinic.com: Gastric bypass
- Medline Plus: Your diet after gastric bypass surgery
- "Archives of Surgery"; Yale Podnos et al.; "Complications after laparoscopic gastric bypass; September 2003.
Member Comments