Gastrointestinal Complications of Bariatric Surgery: Diagnosis and Therapy

  title={Gastrointestinal Complications of Bariatric Surgery: Diagnosis and Therapy},
  author={Thomas L. Abell and Anil Minocha},
  journal={The American Journal of the Medical Sciences},
  • T. Abell, A. Minocha
  • Published 1 April 2006
  • Medicine
  • The American Journal of the Medical Sciences
Severe or morbid obesity, with body mass indexes exceeding 35 to 40, are often refractory to all therapies other than surgery. The increasing number of patients undergoing bariatric surgery will result in increasing numbers of patients with gastrointestinal complications. The types of complications vary with type of surgery, whether restrictive, malabsorptive, or both, depending on what anatomical and physiologic changes occur postoperatively. One complication of bariatric surgery (gallstones… 

Neurologic complications of bariatric surgery.

3 patients who developed unusual and severe neurologic deficits after undergoing bariatric surgery, including Wernicke encephalopathy, acute and rapidly progressive polyneuropathy, myelopathy, and visual deficits are reported on.

Endoscopic treatment of obesity

Gastrointestinal endoscopy has recently been proposed as a scarless and noninvasive approach to obesity and the preliminary results are extremely promising, but definitive statements cannot be drawn yet.

Complications of bariatric surgery

The most common types of bariatric surgery are described, the complications that each can cause are discussed, and the recommended approach for their work-up and management is addressed in order to better equip the gastroenterologist in dealing with this new field.

Pathophysiology, diagnosis and management of postoperative dumping syndrome

Somatostatin analogs are the most effective medical therapy for dumping syndrome, and a slow-release preparation is the treatment of choice, but the outcomes of such approaches are variable.

Gastric Bypass: Gastrointestinal Bleeding

Gastrointestinal bleeding can be a complication of any gastrointestinal surgery. However, in bariatric surgery, and Roux-en-Y gastric bypass surgery in particular, gastrointestinal bleeding can cause

Bariatric Surgery in Children

It has been suggested that bariatric surgery in adolescents may have less complications and a shorter hospital stay than in adults and diligent long-term follow-up of all these patients is required to help determine this.

Post-surgical and obstructive gastroparesis

Initial postoperative management of PSG should be conservative as many symptoms following abdominal surgery resolve with time, but persistent symptoms are difficult to manage and require a multidisciplinary team approach.



Nutrient deficiencies secondary to bariatric surgery

This review describes the literature published in the last few years concerning nutritional deficiencies after bariatric surgery as well as their etiology, incidence, treatment and prevention and gives special attention to adolescents, mainly girls at reproductive age who have a substantial risk of developing iron deficiency.

Early Gastrointestinal Hemorrhage after Laparoscopic Gastric Bypass

Early GI hemorrhage is a potential complication after transected LRYGBP and early reoperative intervention should be performed for patients with hemodynamic instability and patients with early onset of hemorrhage after surgery.

Follow-up of nutritional and metabolic problems after bariatric surgery.

The majority of this review will deal with patients who have had the standard Roux-en-Y gastric bypass, which is a primarily restrictive procedure with a mild component of noncaloric malabsorption.

Bariatric surgery: a systematic review and meta-analysis.

Fatal Pulmonary Embolism after Bariatric Operations for Morbid Obesity: A 24-Year Retrospective Analysis

4 patients demonstrated a combination of risk factors (VSD, BMI ≥ 60, truncal obesity, OHS/SAS) recognized as significant for the development of postoperative VTE, and prophylactic IVC filter placement is highly recommended in such patients.

Acute Post-Gastric Reduction Surgery (APGARS) Neuropathy

The incidence of APGARS in this survey was 5.9 cases per 10,000 operations, and surgeons should be aware of the findings and treatment.

Surgery decreases long-term mortality, morbidity, and health care use in morbidly obese patients.

Concerns are raised about the characteristics of the matched-control subjects and the methods used for matching that generate concern for the possibility of uncontrolled confounding either by comorbidity or by socioeconomic status.

Severe Metabolic Bone Disease as a Long-Term Complication of Obesity Surgery

A 57-year-old woman presented with severe hypocalcemia, vitamin D deficiency, and radiographic evidence of osteomalacia, 17 years after vertical banded gastroplasty and Roux-en-Y gastric bypass, illustrating not only the importance of informed consent in patients undergoing obesity operations, but also the need for adequate follow-up for patients who have undergone these procedures.

Outcomes After Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity

Laparoscopic Roux-en-Y gastric bypass is effective in achieving weight loss and in improving comorbidities and quality of life while reducing recovery time and perioperative complications and in patients with more than 1 year of follow-up.