Obesity Surgery Complications

Gastric Bypass :: Gastric Banding

Complications of Gastric Bypass and Sleeve Gastrectomy

Although it is not the intention to frighten you about weight loss surgery it is important that you are aware of the important risks related to this operation.

Major surgery always runs the risk of major complications. Some complications are extremely rare, and some may have never happened previously. Below are some of the most commonly seen complications as well as important but uncommon complications that you should be aware of.

Mortality

There is an operative mortality risk of 0.5%, generally due to the complications below.

Intraoperative Complications

Bleeding can occur but is generally not a problem. Occasionally a transfusion might be required. Rarely a patient may need to return to theatre.

Respiratory Complications

Sometimes patients can have a small part of the lung collapse which recovers quickly and fully with early mobilisation. This is known as atelectasis

Pneumonia, this is a severe infection of the lung and needs antibiotics and physiotherapy to recover from.

Pulmonary Embolus - Clots developing in the legs can break off and spread via the blood stream to the lungs. Most of the time these are treatable with anticoagulation, there are reported deaths from this however. Efforts are made to reduce the risks of pulmonary embolus by the patient wearing special support stockings, mechanical compression devices and sometimes injections of a blood thinning agent. Early getting out of bed after surgery is important to reduce the risk of this complication. Pulmonary emboli are responsible for one third of death after gastric bypass surgery

Cardiac Complications

These include heart attack, angina and high blood pressure. These are generally not a problem postoperatively unless you have an existing cardiac history. It is most important you get some exercise (such as walking or swimming) prior to surgery to help build up your cardiovascular fitness. Sometimes a cardiology review before surgery may be requested.

Intestinal Leak

Leakage can occur from any of the staple lines or where the bowel has been sutured. This is a serious complication (potentially life threatening) and you may need further urgent surgery and a period of time in the intensive care unit. Occasionally symptoms are minor and will settle down by themselves without further surgery.

Wound Complications

Wound infections occur approximately 5% of the time and although generally not of serious concern can cause considerable discomfort and inconvenience to patients who may require many dressings over a period of weeks.

Incisional hernias can develop. These are less commonly seen after the keyhole approach and may require further surgery

Key Hole Surgery

There is always the risk that your operation may have to be converted to an open operation. This is only done in the interests of patient safety. Recovery time will be slightly longer.

Long Term Complications

Sometimes the anastomosis between the stomach pouch and the bowel scars down and becomes narrowed. This causes nausea and vomiting. This is relatively easy to rectify with an endoscopy and stretch (dilatation) of the anastomosis.

Gallstones can occur in up to 30% of people with rapid weight loss and sometimes the gallbladder will need to be removed at a later date.

Late Weight Regain

This gradually occurs when patients revert to prior eating patterns, in particular snacking and failing to keep up an exercise programme.