Early and late complications of bariatric operation

Abstract

Weight loss surgery is one of the fastest growing segments of the surgical discipline. As with all medical procedures, postoperative complications will occur. Acute care surgeons need to be familiar with the common problems and their management. Although general surgical principles generally apply, diagnoses specific to the various bariatric operations must be considered. There are anatomic considerations which alter management priorities and options for these patients in many instances. These problems present both early or late in the postoperative course. Bariatric operations, in many instances, result in permanent alteration of a patient's anatomy, which can lead to complications at any time during the course of a patient's life. Acute care surgeons diagnosing surgical emergencies in postbariatric operation patients must be familiar with the type of surgery performed, as well as the common postbariatric surgical emergencies. In addition, surgeons must not overlook the common causes of an acute surgical abdomen-acute appendicitis, acute diverticulitis, acute pancreatitis, and gallstone disease-for these are still among the most common etiologies of abdominal pathology in these patients.

Keywords: acute care surgery; complications; morbid obesity.

Figure 1

Lap band phi angle (ɸ). (A) Angle of 45° indicating good position. (B) Angle greater than 58° indicating slipped band.

Figure 2

Internal hernias of retrocolic Roux-en-Y gastric bypass. (A) Transverse mesocolic defect. (B) Petersen’s defect. (C) Jejuno-jejunostomy mesenteric defect.