Gastric Bypass Surgery: Risks and Complications

Gastric Bypass Surgery is suggested in the case of people suffering from physical limitations caused by the onslaught of morbid obesity and related ailments. The procedure involves dividing the stomach pouch into two distinct segments. The upper pouch is usually kept smaller than the lower or remnant pouch. The surgeon then re-arranges the small intestine to ensure connectivity with both pouches. This surgery leads to a major reduction in the stomach's functional volume, which in turn triggers an alteration in the psychological and physiological response to food. The surgery is performed to help people suffering from morbid obesity. The altered stomach chamber and subsequently the digestive system results in the desired weight loss. However, the surgical procedure is not without risks and complications.

Possible Complications

Though Gastric Bypass Surgery dramatically reduces comorbidities, statistics reveal that the surgery is also associated with reduced motility in 40% cases and surgery-related death. The triggered metabolic effects, post-surgery, can lead to life-threatening health problems that arise from deterioration of health and a lowered quality of life. The complications that are common to all abdominal operations include infection of the incisions due to release of bacteria during the operation and hemorrhage. Nosocomial infections such as sepsis, pneumonia and kidney infections have been reported post-Gastric Bypass Surgery. Internal hernia may result from the re-arrangement of the bowel, while the instance of incisional hernia cannot be ruled out as a result of a surgical incision that does not heal well enough. Bowel obstruction, venous thromboembolism, anastomotic leakage/stricture/ulcer and Dumping Syndrome are some of the other Gastric Bypass Surgery complications on record. The surgical procedure is also associated with the onset of nutritional deficiencies of calcium, iron, vitamin B12, thiamine and vitamin A. Protein malnutrition is another complication that could set in post-surgery. In this condition, the patient only stops vomiting after the gastrointestinal tract adjusts to the changes.

Associated Risks

Statistics reveal that the risk factor involved in Gastric Bypass Surgery is around 7% in the case of laparoscopic procedures and 14% in the case of open incision surgical procedures. Mortality is largely affected on account of the onset of complications that are triggered by the instance of pre-surgery factors such as:

• Heart disease
• Degree of obesity
• Obstructive sleep apnea
• Diabetes mellitus
• Pulmonary embolism
• High Blood Pressure
• Gastroesophageal reflux disease
• Gallbladder disease
• Liver disease
• Degenerative disc disease
• Osteoarthritis

Gastric bypass surgery results in the patient feeling 'full' after a small meal intake. This marked reduction, in the volume of ingested food and subsequent loss of appetite, results in the need to address the body's requirement of protein, vitamins and minerals. Most of the time liquid or solid supplements are prescribed. It is very important to adhere to the recommended criteria while considering Gastric Bypass Surgery. These include ensuring that the operation is performed only in the case of a person who exhibits a body mass index (BMI) of more than 40 or more than 35, with the manifestation of some co-morbid condition. With the correct approach, Gastric Bypass Surgery is known to reduce hyperlipidemia in over 70% patients, while reversing the onslaught of diabetes mellitus type 2 in up to 90% patients. The surgery should ideally be considered as a 'tool' to help the patient cope with related comorbidities and limited physical activity. The resultant alterations in lifestyle and eating habits effectively help obesity management only after comprehensive pre-operative evaluation and the development of multidisciplinary support.