Complications of a gastric bypass Complications can be divided into early (< 30 days) and late. Early complications include mortality (0.3%), anastomotic leaks (2%), gastrointestinal bleeding (2%), pulmonary embolus (0.4%), and wound infection (3%). Late complications include anastomotic stenosis (5%), small bowel obstruction from internal hernias (3%), marginal ulceration (10%), cholelithiasis (10%), and vitamin and …
How does the gastric bypass and biliopancreatic diversion cure diabetes prior to weight loss? This is more complex than calorie restriction and involves changes in gut hormones. Bypassing the duodenum and proximal jejunum (the proximal gut theory) changes gastric inhibitory polypeptide hormone levels and likely other as yet unknown hormonal levels that play a role …
What are the weight loss expectations after each procedure? Success following bariatric surgery is determined by both weight lost and improvement in obesity-related comorbidities. Most surgical studies report outcome as % excess weight loss (excess weight = preoperative weight – ideal weight). Gastric banding typically produces 40% to 50% excess weight loss over 2 to …
Combined restrictive malabsorptive surgery for Obesity Known as the Roux-en-Y gastric bypass, the restrictive-malabsorptive option has been performed in the United States for nearly 50 years. It has been performed laparoscopically for the past 15 years and historically is the gold standard and most common operation for weight loss in this country. The procedure is the performed …
Options for restrictive surgery • Vertical-banded gastroplasty: A stapling device is used to divide the stomach vertically along the lesser curve starting at the angle of His to create a small (20-mL) pouch. A prosthetic nonadjustable device is then wrapped around the outlet of the pouch to prevent it from dilating over time. This operation has fallen …
Have there been any updates to the 1991 NIH surgical indication criteria? There have not been any NIH updates; however, there has been a trend in extending surgical criteria to those with BMIs less than 35. The International Diabetes Federation added to their position statement in 2011 that bariatric surgery should be considered for those …
What was the NIH consensus conference statement? Those with severe clinical obesity defined as a BMI of 40 or more (morbid obesity) or a BMI of 35 to 39 with severe, debilitating comorbidities are best treated with a surgical weight loss procedure.