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.

Unacylated ghrelin is correlated with the decline of bone mineral density after Roux-en-Y gastric bypass in obese Chinese with type 2 diabetes

“…They were carried out in a lower body mass index (BMI 27.5 kg/m 2 ) for Chinese people owing to racial difference. However, some side effects have been reported, such as anemia, infections, gallstones, and dyspnea [2]. Subsequently, several studies found that bone mineral density (BMD) was obviously affected after gastric surgery, especially at the femoral neck (FN) and total hip (TH) [2].…”

“…However, some side effects have been reported, such as anemia, infections, gallstones, and dyspnea [2]. Subsequently, several studies found that bone mineral density (BMD) was obviously affected after gastric surgery, especially at the femoral neck (FN) and total hip (TH) [2]. It becomes an urgent problem to be resolved and draws our attention [3].…”

Increased energy expenditure and protection from diet-induced obesity in mice lacking the cGMP-specific phosphodiesterase, PDE9

“…These include appetite suppressants and blockade of fat absorption (4), but are frequently accompanied by unacceptable side effects or eventual lack of efficacy. More recently, invasive procedures such as bariatric surgery have also been prescribed (4), and while to date this approach has proven effective at ameliorating insulin resistance and providing sustained weight loss, the risks associated with such radical surgeries are not to be underestimated (5). On the other hand, one potential means to increase energy expenditure aside from physical exercise is energyconsuming futile metabolic cycles and uncoupled respiration (6).…”

Improving Access to Bariatric Surgery for Rural and Remote Patients: Experiences from a State-Wide Bariatric Telehealth Service in Australia

“…Australian and International guidelines recommend bariatric surgery should only be offered in high-volume, specialized units with adequate allied-health support and follow-up capability [2,3]. This is required to prevent late weight regain and avoidable complications such as nutritional deficiencies [4,5]. Increased patient geographical distances from bariatric units are associated with poorer follow-up and potentially poorer outcomes [6][7][8].…”