Abstract
Bariatric surgery is the only effective long term treatment of morbid obesity. With the establishment of an accreditation process for bariatric centers and the development of laparoscopic approaches to bariatric surgery, in addition to fellowship training, bariatric surgery became a role model for other surgical specialties in terms of efficacy and safety. Bariatric surgery has now a long track record of safety and a very low morbidity and mortality rates. In addition, the number of bariatric procedures being performed is increasing dramatically. Health care providers caring for bariatric patients will encounter on occasions certain complications specific to bariatric patients in the immediate postoperative period. The objective of this review is to illustrate some of the immediate postoperative complications following bariatric surgery to provide general guidelines for a timely diagnosis and management of postoperative patients. These bariatric specific complications include gastrointestinal leakage, gastrointestinal bleeding and small bowel obstruction. We will also discuss the diagnosis of postoperative thromboembolic and cardiac diseases in bariatric patients.
Highlights
GI leakage usually occurs in the immediate postoperative period but rarely may present several weeks following surgery and Bariatric surgery is the only effective and proven long-term solution for the treatment for morbid obesity [1]
Some authors have suggested that the leakage rates after laparoscopic roux-en-y-gastric bypass (LRYGB) are higher than when performed in an open fashion possibly due to surgeon experience and learning curve [9]
Intubation is recommended to secure the airway, help prevent aspiration and quickly convert to operative interventions if required
Summary
Gastrointestinal (GI) leakage is one of the most devastating complications that can be encountered following bariatric surgery. The possible sites of leakage are primarily from staple lines leaks can result from any anastomosis whether stapled, hand sewn or a combination of the two (Figure 1). Missed serosal injuries or enterotomies at the time of surgery are another likely source. GI leakage usually occurs in the immediate postoperative period but rarely may present several weeks following surgery and
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