Risks and Complications
General risks:
All abdominal operations carry the risks of bleeding, infection in the incision, potential problems with the heart and/or lungs, obstruction (blockage) of the intestine caused by adhesions, hernia through the incision, rejection of suture materials, and the risks associated with general anesthesia. These risks are not significantly greater in most morbidly obese patients than in normal-weight patients.
Risks Specifically Related to Gastric Reduction Operations:
Early risks:
Leakage of fluid from the stomach or intestine through the staples or sutures which results in abdominal infections. This potentially serious complication (3-20 percent in medical literature) usually required a second operation for drainage of infection.
Injury to the spleen. This is a very uncommon (5 percent) complication which may require removal of the spleen if bleeding cannot be controlled.
Late risks:
The formation of ulcers in the stomach or small intestine. This is a rare complication which occurs in approximately 4 percent of patients after gastric bypass surgery.
Dumping. Patients may develop loose stools and/or abdominal cramps shortly after eating certain types of foods. These symptoms can be avoided by not eating the offending foods. Diarrhea is uncommon after gastric reduction surgery and can be successfully treated with medication. Dumping is occasionally associated with brief periods of light-headedness, sweating or heart palpitations. These symptoms can usually be reduced by drinking a sweet liquid like fruit juice.
Obstruction of the stoma. This rare complication occurs in less than 1 percent of gastric bypass patients and can occur when a piece of food becomes lodged in the stoma. When this happens, the piece of food is removed through a tube (endoscope) passed from the mouth into the stomach. Over time, rarely the stoma can be narrowed by scar tissue.
Vitamin and/or iron deficiency. This may occur in a mild form in as many as 30 to 40 percent of patients after gastric bypass. Iron and some vitamins, most notably B-12, are primarily absorbed in the stomach and upper part of the small intestine which is bypassed. Both the vitamin and iron deficiencies are easily treated by either oral supplementation or injections.
Inaccessibility of the distal stomach and upper intestine to diagnostic tests such as upper gastrointestinal (GI) X-ray and upper GI endoscopy. When the stomach is closed off in a gastric bypass, there is no way for contrast materials or an endoscope to reach the bypassed stomach (the part of the stomach below the staples). This would make diagnosis of a problem such as an ulcer of the distal bypassed stomach more difficult. The incidence of problems occurring in the bypassed part of the upper GI tract is extremely low.
Staple disruption can occur at any time after this operation but is uncommon (less than 1 percent). If staples pull out, the feeling of fullness will disappear, as the stomach will be accessible to ingested food.
To locate a Lourdes Health System bariatric surgeon by phone, call 1-888-LOURDES.
