Why is the sleeve gastrectomy popular? It has less long-term risk compared with the gastric bypass and biliopancreatic diversion (less marginal ulcers, small bowel obstruction, and vitamin and mineral deficiencies) and less maintenance than gastric banding, and the weight loss and comorbidity improvement results are good and lie between gastric banding and gastric bypass.
What are the specific complications after gastric banding? Complications are erosion of the band through the pouch (1%), slippage or prolapse of the band around the pouch (5%), band migration and esophageal obstruction (5%-10%), port or tubing break or infection (< 5%), and need for reoperation (at least 10%). What is the long term failure …
Gastric banding procedure over a Roux en Y gastric bypass? It is safer. It is simple to place and reversible as there is no anatomic reconfiguration. It also avoids vitamin and mineral deficiencies. It requires close follow-up for best results.
What are the vitamin and mineral deficiencies and potential long term risks? Vitamin B 12 , folate, and iron deficiencies occur in up to 40% of patients without lifetime supplementation. Hypocalcaemia with or without vitamin D deficiency and resulting osteoporosis can also occur without lifelong supplementation. The deficiencies are a result of bypassing most of the stomach, …
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How is an anastomotic stenosis treated? Many surgeons purposely make the gastrojejunostomy anastomosis small (approximately 0.8 cm) to enhance the restrictive aspect of the operation. If this anastomosis becomes too small for the patient to tolerate, endoscopic balloon dilatation is usually successful.
What is a marginal ulcer and how is it treated? A marginal ulcer is usually found on the jejunal side of the gastrojejunostomy. It is often related to local ischemia, smoking, or nonsteroidal antiinflammatory drug use and usually heals with proton pump inhibitor or sucralfate therapy.
How are anastomotic leaks handled? These are usually at the gastrojejunostomy anastomosis and can be treated conservatively with total parenteral nutrition (TPN), maintaining nothing by mouth, percutaneous catheter drainage, and possibly covered stent if the patient is stable. For anastomotic leaks in an unstable patient or a nonhealing fistula, surgical repair necessary.