Risks of Gastric Bypass Surgery
What are the Risks of Gastric Bypass Surgery?
As with all surgery, complications are a possibility. Statistics indicate that about one patient in 200 will not survive the surgery or the immediate postoperative period. This number is highly variable depending on how "high risk" you are as a patient and also on the experience of the team taking care of you. In our experience at MUSC, much like other large programs, the most common causes of death are pulmonary embolus (blood clot to the lungs) and peritonitis (infection in the abdomen) from a leak from any of the hook-ups between pieces of intestine or to the pouch. Most of the other complications occur when you have left the hospital following gastric bypass surgery, but are not life threatening. We handle most of these in the clinic or over the phone.
Wound infection: may require long term treatment (sometimes months) with dressing changes, but almost always heal on their own without further surgery.
Incisional hernia: a weakness or defect in the incision after an open operation that may allow intestine or tissue to bulge through; may be caused by trying to do too much too soon after your gastric bypass surgery. You can help prevent this complication by following our suggestions (no heavy lifting, no heavy housework, etc. for at least six weeks, or as prescribed by the surgeon after surgery). The only treatment is surgical repair.
Stomal stenosis: too tight an opening between the stomach and the intestinal "hook-up". This can be treated by inserting a lighted tube through the mouth to the tight area and stretching it with a balloon.
Stomal ulcer: usually heal with an anti-ulcer medication. To help prevent ulcers after surgery, we give all patients a prescription for Pepcid for one month or similar anti-ulcer medication.
Gallstones: prior to your surgery, you will have an ultrasound of your gallbladder to see if you have gallstones. If you have any stones or gallbladder disease, your gallbladder will be removed at the same time as the gastric bypass surgery. However, if you have a healthy gallbladder, it will be left in place. You will then be treated with a gallstone prevention medication called Actigall for six months.
Blood clots: a blood clot to the lungs, or pulmonary embolism, a possible complication after any surgery, can be very serious. For this reason, we take extra steps to prevent this problem.
- All patients are given a blood thinner after surgery
- "Compression hose" are used to help with circulation during and after surgery
- All patients are required to get out of bed the night of gastric bypass surgery
Leak: a leak from any of the "hook-ups" is one of the most serious complications. Although rare (1-2%), this complication can be extremely serious and potentially fatal. For this reason, some patients are checked for a leak before leaving the hospital. This is done by an upper GI series (an x-ray with barium). All patients have an upper GI series after a laparoscopic gastric bypass. If a leak occurs, emergency surgery may be necessary.
Long term complications: may include vitamin B12 deficiency (having too little B12 in your body), calcium deficiency (which increases risk of brittle bones or osteoporosis), and iron deficiency anemia. To minimize the potential for these problems, we insist that all patients take lifetime daily vitamin supplements (multivitamin, B12 and calcium) and iron (for menstruating females). We also require lifetime follow-up with the surgeon, including yearly blood work to identify problems.
Inadequate weight loss: another possible complication, is usually preventable and treatable with patient compliance (following the guidelines we give you). We highly recommend that all patients eliminate sweets and high fat, high calorie foods from the diet. This complication may also be caused by a "staple disruption" (a break in the staples dividing the stomach pouch and the rest of the stomach). This problem may allow the patient to eat larger quantities of food, potentially causing weight gain or inadequate weight loss.
Non Surgical Programs at MUSC
The MUSC Weight Management Center offers a wide range of non-surgical and research programs.
We offer programs to serve the different needs of different people. However, all of our work with patients includes a strong emphasis on helping them to make the long-term lifestyle changes that are so important for success in the long run.
More information on our Weight Management Center