Complications of bariatric surgery
Perioperative (30-day) mortality for bariatric procedures has fallen to approximately 0.1% overall, comparable with that for cholecystectomy or hip replacement.
The laparoscopic technique has changed the pattern of perioperative complications.
Wound complications and postoperative cardiopulmonary complications are less frequent, whereas anastomotic stenosis, GI bleeding, and bowel obstruction occur more frequently with laparoscopic techniques compared with open techniques.
Mean hospital stay after laparoscopic bariatric surgery is 1 to 3 days, which is significantly shorter than after open surgery (5–7 days).
Thus, all procedures should be done laparoscopically, if possible.
The lap band is usually performed as either an outpatient procedure or requires a 24-hour stay.
Each procedure has its own unique risk of complications, the lap band having the lowest number of serious complications but the highest reoperation rate and the biliopancreatic diversion having the highest serious complication rate.
Incidence of complications after laparoscopic bariatric surgeries
- • Anastomotic leak (1%)
- • Anastomotic stenosis (5%–10%)
- • Postoperative bowel obstruction (3%)
- • GI bleed (2%)
- • Gallstones (10%)
- • Protein-calorie malnutrition (3%–5%)
- • Anemia (30%)
- • Vitamin deficiency (30%)
- • Wound complications (infection, dehiscence, and hernia) (4%–5%)
- • Band slippage or erosion into stomach (1%–5%)