Complications Of Gastric Bypass Surgery

Gastric bypass is one of two types of procedures performed in the United States as a treatment for morbid obesity. The Mayo Clinic states that the procedure is performed on patients with a body mass index (BMI) greater than 40 or in patients who have a body mass index greater than 35 with serious weight-related health problems. It is most commonly performed via the Roux-en-Y method which involves creating a small stomach pouch with a gastric stapler and attaching a more distant portion of the small intestine to the stapled area. This creates a bypass around a section of small intestine responsible for food absorption. As with any surgical procedure, there are risks of bleeding, infection and blood clots; however, gastric bypass carries additional risks that are unique to the procedure.

Leaking at Staple Lines

The surgical junction of two organs or vessels is termed an anastomosis. Anastomotic leak is a complication of any digestive surgery and can have severe results. The digestive contents are not sterile, and the leakage of these contents into the body can cause systemic infection. Although rare, this complication most often occurs at the junction of the intestine and the stomach, and can be brought on by severe coughing in the recovery room causing sutures to tear out. Small leaks that are contained can be treated with antibiotics; however, any signs of a continued leak must be treated surgically. Patients with this complication will often have difficulty breathing, suffer pain that is not relieved with medicine and have low blood pressure. Recovery personnel are specifically trained to look for these signs in the post-operative period.

Dumping Syndrome

Because gastric bypass shrinks the stomach and shortens the amount of small intestine through which food passes, patients can experience severe diarrhea, nausea and vomiting after the procedure. This complication occurs in 25 50 percent of patients undergoing any type of gastric surgery; however, it usually resolves with time, and only 1 to 5 percent experience severe chronic symptoms. The incidence is further reduced by the strict diet requirements that gastric bypass patients adhere to after the procedure, all but eliminating this complication in the long term.

Pneumonia

Pneumonia is a possible complication after undergoing any procedure that requires general anesthesia. Because patients are maintained on a ventilator during the procedure, they don't have the ability to take a large, uncontrolled breath to open small airways that collapse normally over time. The collapse of these airways during anesthesia is often coupled with a lack of deep breathing after surgery due to post-operative pain. When these airways remain collapsed for a long period of time, fluid can accumulate in the lung and lead to infection. This problem is further exacerbated in overweight individuals who have an even harder time taking large breaths after surgery. Prevention of this complication involves adequate pain control so that deep breathing can be accomplished and using a device called an incentive spirometer to help open collapsed airways.