The following is a detailed list of possible complications of bariatric surgery. Many of these are potential complications of any surgery. Morbidly obese patients are at a higher risk when having any surgery due to their excess weight. Often the patient may feel normal prior to surgery, but may have underlying medical problems that they simply did not recognize. Long term poor nutrition that has led to morbid obesity often leads to poor heart and lung health.
Our team is committed to making your surgery as safe as possible. Advancements in the care of bariatric patients over the past 20 years have allowed us to perform these surgeries with very low complication rates. Your personal risks will be individually evaluated at your consultation with your surgeon. It is important to remember that the risks of staying morbidly obese far outweigh the risks of surgery.
The following is a list of risks possible with bariatric surgery:
If you have difficulty in the hospital, a lung specialist (pulmonologist) may assist with your care. You must stop smoking prior to gastric bypass surgery to decrease your risk of complications.
- Atelectasis (poor lung expansion due to poor breathing effort)
- Respiratory failure (needing prolonged ventilator)
- Pulmonary embolism (blood clot in the lung)
- Heart attack
- Blood clots
- Congestive heart failure
- Irregular rhythm
- Blood pressure unstable (too high or too low)
- Fatty tissue does not heal well and increases risks of infection
- Wound infection
- Sepsis/peritonitis (infection in the blood stream or abdomen)
- Breakdown or opening of wound
- Bladder infection
Any area where the stomach or intestine has been disconnected or connected may leak and cause serious infection. If this infection spreads through the body, it may be life threatening. Leakage can occur at the skin wound (often drains some non-infected fluid), at the anastomosis (leakage from the connection of intestine to the pouch, the intestine to intestine connection or the stomach remnant), and if there is wound dehiscence (separation of the abdominal wall and organs exposed).
The most common cause of bowel obstruction is scar tissue. When this occurs at the site of the anastomosis, it is called a stricture. It can occur shortly after surgery or many years later. Obstruction can happen in the bowel or at the anastomosis. A volvulus or internal hernia (twisting of the bowel) can also cause obstruction.
Even with careful precautions, there remains a small risk of bleeding with any surgery. If this becomes excessive, it may require that you receive blood and/ or blood products. Rarely, you may require further surgery to control the bleeding. Since the spleen is very close to the site of the surgery, there is a small chance that it could bleed significantly and require removal to control the bleeding. You can have bleeding into the intestine or into the abdomen.
This is usually due to overfilling of your new stomach pouch. This can be caused by eating or drinking too fast. This improves as your new pouch empties better over time. It may also be due to a stricture (tightening) of the connection between the stomach pouch and intestine. Occasionally, this can be prolonged without any good explanation.
Dehydration/ Electrolyte Abnormality
Water is crucial for normal function of your body. Due to your altered anatomy, you are at increased risk for dehydration with vomiting and diarrhea. It is important to drink at least 64oz of water daily and more when ill.
This is a risk of any surgery. You are at increased risk due to the size of your abdominal wall. This produces a bulge in your abdominal wall. Corrective surgery may be delayed during the rapid weight loss phase as long as you have minimal discomfort and the hernia is not enlarging.
Change in Bowel Habits (diarrhea/ constipation
This is usually related to your new anatomy. It is very common to have increased gas. The consistency of your stool is often related to your diet. Constipation can occur due to the required high protein diet and if consuming inadequate amounts of water. An over the counter Fiber supplement of your choice can help with constipation.
Several vitamin deficiencies are possible. The most common deficiencies are: Iron, Vitamin B12, B1, D, A, and Calcium.
Inadequate weight loss or weight regain
Like all weight loss surgery, the surgery is only a tool to assist with weight loss. To be successful patients must follow the diet, exercise, and surgery recommendations. Grazing eating behaviors, high calorie liquids and night eating may lead to poor weight loss or some weight regain.
This surgery has been refined to the point that death is very rare. However, it does remain a possibility due to the fact that your body is not healthy at your current weight. The risk of dying from bariatric surgery is less than 1%. You are at much higher risk of dying from the diseases caused by your obesity then from surgery.
Treatment of Complications
Your bariatric team is experienced in caring for any possible complication that may occur. If necessary, additional specialists may assist with your care in their areas of expertise. Most complications can be effectively treated, but they may prolong your recovery.
Risks of Sleeve Gastrectomy
All of the above listed risks apply to the sleeve gastrectomy with the addition of:
Reflux or Heartburn
This is the most common complication following a sleeve gastrectomy. Between 10-20% of patients may need medicine to treat reflux after a sleeve. Many of these patients experienced these same symptoms before having surgery and just continue to have these symptoms after surgery.