Risks
Bleeding
As with any major surgery, bleeding can occur. Rarely is there significant
blood loss associated with bariatric surgery. If bleeding occurs, there
is the possibility that a blood transfusion may be necessary. Blood would
only be given if the doctor feels it is absolutely necessary.
Deep
Vein Thrombosis
Obesity and immobility (due to surgery)
can cause blood to pool in the lower extremities.
When this occurs, blood
clots can
form. Giving patients blood thinners, having patients wear compression
stockings, and ambulating reduces the risk of deep vein thrombosis.
Pulmonary Embolus
When a blood clot that forms in the leg breaks loose and travels to
the lung, it is called a pulmonary embolus. Like a deep venous thrombosis,
a pulmonary embolus is a risk in any type of surgery for obese patients.
Giving patients blood thinners before and after surgery reduces
the risk. Individuals who are felt to be at high-risk for pulmonary
embolus may have as special filter placed to decrease the likelihood
of a clot moving to the lungs.
Wound Infection
Wound infection can occur after bariatric surgery. Intravenous antibiotics
given at the time of surgery can decrease the risk of infections.
Anastomotic Leak
The anastomosis is the location where the stomach and intestines are
connected together during surgery. There is a small risk of leakage
at this connection. If a leak were to occur, intestinal contents
would spill into the abdominal cavity. This can cause infection.
Surgeons test the anastomosis in the operating room during surgery
or in the radiology department after surgery.
Ulceration
Ulcers can occur in the stomach or small intestine following surgery.
Patients may be placed on an acid suppressing medication for three
months following surgery. If ulcers occur, they are treated with medication
and occasionally intravenous nutrition.
Pneumonia
Due to immobility around the time of surgery, patients are at risk
for developing pneumonia. This is prevented by having the patients
use an incentive spirometer every hour while hospitalized and ambulating.
Walking helps to improve the movement of mucus and secretions from
the lungs.
Hernia
A hernia can occur after any abdominal surgery. A hernia occurs when
the intestine comes through the weakened abdominal wall. The abdomen
is weakened due to the incision created at surgery. To decrease the
likelihood of getting a hernia, patients are advised to refrain from
lifting greater than 15 pounds for two months after surgery, and refraining
from strenuous activity for two to three months following surgery.
Dumping Syndrome
Dumping syndrome can occur following gastric bypass surgery. Patients
may experience, diarrhea, sweating, heart palpitations, nausea, and
dizziness. Patients may experience dumping when they consume concentrated
sweets or fried foods. This condition can be minimized with patient
compliance to the postoperative gastric bypass diet.
Nausea and Vomiting
Most patients experience some nausea and vomiting in the first few
weeks following surgery. Nausea may be a sign of dehydration or obstruction.
This usually improves as patients learn how to eat and drink slowly,
to avoid eating and drinking at the same time, and to recognize the
feelings of fullness. If vomiting becomes persistent, the patient
needs to be evaluated for a stricture.
Stricture
Strictures can occur where the stomach and intestine are attached. For
some patients, when they heal, this connection gathers scar tissue.
If this occurs, patients experience frequent nausea and vomiting. Treatment
of a stricture involves an endoscopy and dilation. A balloon is used
to stretch the opening and dilate the stricture. Repeated efforts be
needed to keep the stricture open.
Hair Loss
Some patients will experience thinning of the hair during the first six
months after surgery. This is due to lack of protein in their diet.
This condition will usually reverse itself after six months.
Nutritional Deficiencies
Due to the change in both the stomach and intestines after surgery, patients
are at risk for developing nutritional deficiencies. It is imperative
to remain on the vitamin and mineral supplements recommended by the
nutritionist for life. Lab work should be checked periodically following
surgery to ensure that nutritional deficiencies have not occurred.
Bowel Obstruction
Bowel obstruction may
occur after any abdominal operation. This may
be due to twisting of the intestine or scar tissue
that may form.
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