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Review
. 2009 May;91(4):280-6.
doi: 10.1308/003588409X392072. Epub 2009 Apr 2.

Complications of bariatric surgery: presentation and emergency management--a review

S J W Monkhouse  1 , J D T Morgan, S A Norton
Affiliations
Review

Complications of bariatric surgery: presentation and emergency management--a review

S J W Monkhouse et al. Ann R Coll Surg Engl. 2009 May.

Abstract

Introduction: The prevalence of obesity surgery is increasing rapidly in the UK as demand rises. Consequently, general surgeons on-call may be faced with the complications of such surgery and need to have an understanding about how to manage them, at least initially. Obesity surgery is mainly offered in tertiary centres but patients may present with problems to their local district hospital. This review summarises the main complications that may be encountered.

Materials and methods: A full literature search was carried out looking at articles published in the last 10 years. Keywords for search purposes included bariatric, surgery, complications, emergency and management.

Conclusions: Complications of bariatric surgery have been extensively written about but never in a format that is designed to aid the on-call surgeon. The intricate details and rare complications have been excluded to concentrate on those symptoms and signs that are likely to be encountered by the emergency team.

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Figures

Figure 1
Figure 1
The main types of bariatric surgery available. Reprinted with permission of the American Society for Metabolic and Bariatric Surgery © 2008, all rights reserved. A, biliopancreatic diversion (BPD); B, biliopancreatic diversion with duodenal switch (BPD/DS); C, Roux-en-Y gastric bypass (RYGB); D, laparoscopic adjustable gastric band (LAGB).
Figure 2
Figure 2
Good band position on barium swallow. Note 45° of band, no pouch dilatation and flow of contrast through the band.
Figure 3
Figure 3
An acute gastric band slip. Note the horizontal lie of the band and the dilated pouch above the band. Contrast does not flow through the band.
Figure 4
Figure 4
A plain emergency X-ray showing a gastric band in situ (good band position).
Figure 5
Figure 5
The subcutaneous inflation/deflation port and gastric band. Note the smooth dome which should be palpable. A Huber needle used for inflation/deflation is shown.
Figure 5
Figure 5
The subcutaneous inflation/deflation port and gastric band. Note the smooth dome which should be palpable. A Huber needle used for inflation/deflation is shown.
See this image and copyright information in PMC

Comment in

  • Comment on: A plethora of gastric bands.
    Diggory RT. Diggory RT. Ann R Coll Surg Engl. 2009 Nov;91(8):719; author reply 719. doi: 10.1308/003588409x12486167521433. Ann R Coll Surg Engl. 2009. PMID: 19909618 Free PMC article. No abstract available.

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