|
Risks
Associated with
Gastric Bypass
Surgery
Statistics show that 1 in 300
die from gastric bypass surgery. People who suffer from morbid obesity can have other
serious medical conditions which are related to or caused by being
overweight. The higher your
BMI is, the more likely it is that other
medical problems will exist. Other medical problems can increase the risk
of complications from gastric bypass surgery and the recovery period after
gastric bypass surgery.
Another risk factor is age, although this increases the need for surgery
there is generally a higher risk. Any medical procedure that involves
humans and reactions to stress, trauma, drugs, and other causes,
unpredictable negative results can and will occur. This surgery should be
considered only after many attempts with other diet control and exercise
have failed. Diet and exercise will be required before and
after this
surgery.
Statistical data
associated with this gastric bypass surgical procedure include:
- Failure to lose weight
(about 10%)
- Some complication of surgery (10% - 15%)
- Serious,
life-threatening complication (about 2% - 3%)
- Death (less than
1%)
On the other hand, the
risks associated with morbid obesity
far outweigh the risks associated with surgery. For example,
studies prove that the individual who is 100% over ideal weight has a risk
of mortality that is ten times that of a slender counterpart (that is, an
obese individual's chance of dying is ten times as great in any given
year). There is no question that the potential benefits of surgery
outweigh the risks.
Since
gastric bypass surgical procedures result in some loss
of absorptive function, the long-term consequences of potential nutrient
deficiencies must be recognized and adequate monitoring must be performed,
particularly with regard to vitamin B12, folate, and iron. Some patients
may develop other gastrointestinal symptoms such as "dumping syndrome" or
gallstones. Occasionally, patients may have postoperative mood changes or
their pre-surgical depression symptoms may not be improved by the achieved
weight loss. Thus, surveillance should include monitoring of indices of
inadequate nutrition and modification of any preoperative disorders. The
table below illustrates some of the complications that can occur following
gastric bypass surgery.
Gastric Bypass Surgery Complications: 14-Year
Follow-Up
| Gastric
Bypass Surgery Complications |
Number |
Percent |
| Vitamin B12 deficiency |
239 |
39.9 |
| Readmit for various reasons |
229 |
38.2 |
| Incisional hernia |
143 |
23.9 |
| Depression |
>142 |
23.7 |
| Staple line failure |
90 |
15.0 |
| Gastritis |
79 |
13.2 |
| Cholecystitis |
68 |
11.4 |
| Anastomotic problems |
59 |
9.8 |
| Dehydration malnutrition |
35 |
5.8 |
| Dilated pouch |
19 |
3.2 |
Recommendation:
Gastric
bypass surgery is
an option for carefully selected patients with clinically severe obesity
(BMI 40 or 35 with comorbid conditions) when less invasive methods of
weight loss have failed and the patient is at high risk for
obesity-associated morbidity or mortality. Evidence Category B.
After gastric bypass surgery, an occasional
patient may have a complication relating to the staple line or the outlet
of the pouch. For example, there might be leakage, perforation, or
bleeding where some staples are dislodged by overstretching of the
pouch. Other possible complications are formation of an ulcer or
stricture or failure of the staple line to heal properly. These kinds of
problems might make additional surgery necessary. Though all precautions
are taken to prevent them, complications occasionally occur.
For the first month or
so, the patient may experience nausea and vomiting until he or she becomes
accustomed to the new small stomach. Afterwards, patients enjoy a feeling
of satisfaction with small amounts of food.
About one out of
twenty-five patients may need to be readmitted to the hospital because of
vomiting. In the first few weeks after surgery, vomiting may be caused by
swelling at the operative site. Later, there is a possibility that
vomiting might be caused by formation of a stricture, by scarring of the
outlet of the stomach pouch, or by obstruction of the pouch outlet by a
lump of poorly chewed food, tablet, or other foreign body. In most cases
these complications can easily be corrected, without additional formal
surgery.
Because of the
limitation of food intake, supplemental vitamins must be taken. Vitamin
supplementation will always be necessary to minimize the risk of anemia,
weakness, muscular uncoordination, and clinical depression. During the
first few weeks following surgery, a liquid or chewable vitamin is
advised. Afterwards, any good multivitamin preparation containing
adequate amounts of the B-complex vitamins and minerals is sufficient.
There is some
evidence that babies may be born with congenital abnormalities when there
is rapid weight loss during pregnancy. Therefore, pregnancy should be
avoided until weight has stabilized. Once weight has stabilized, there
are no contraindications to pregnancy.
|
