scholarly journals Early and late complications after gastric bypass: A literature review

2021 ◽  
Author(s):  
V. O. Nevmerzhytskyi

Over the last few decades, excess weight and obesity have become a considerable health problem that has a lasting impact on communities worldwide. According to the WHO, about 1.9 billion people over the age of 18 are overweight [32]. Obesity accounted for about 4.7 million premature deaths in 2017. Globally, obesity was associated with an increase in mortality rate from 4.5 % in 1990 to 8 % in 2017 [32]. Bariatric surgery is currently recognized as the most effective treatment option for morbid obesity. Over the past 10 years, gastric bypass surgery has proved more effective than any other surgical methods due to its optimal metabolic effects. The aim of the review is to carry out an analysis of literature data in order to identify main complications after gastric bypass in patients with obesity. The complication rate after bariatric surgery decreased from 10.5 % in 1993 to 7.6 % in 2006 [3]. The mortality rate after bariatric surgery was 0.08 % within 30 days after surgery and 0.31 % after 30 days [13]. According to the BOLD study (2010), for 57,918 bariatric operations, the complication rate was 6,240 (10.77 %) and the mortality rate was 78 (0.135 %), within 30 days after surgery — 0.089 %, within 90 days after surgery — 0.112 %. Roux‑en‑Y Gastric Bypass (RYGB) was carried out in 30,864 cases, and 4,588 (14.87 %) patients developed postoperative complications. Early complications include anastomotic leaks (0 — 5,6 % for laparoscopic approach and 1,6 — 2,6 % — for laparotomy), small bowel obstruction caused by a blood clot (0 — 0,5 %), bleeding from the sutures (1,5 %), and thromboembolic complications (0,2 — 5 %). Late complications include stenosis of the gastrointestinal tract (3 — 27 %), marginal ulceration (MU) — 0,6 — 16 %, an incarcerated Petersen’s space hernia — 2,51 %, perforation of the stomach and small intestine (1 — 2 %), gastrogastric fistula formation — 1,5 — 6,0 %, weight regain (to 17,1 %). Increasing global demand for bariatric surgery as the best option for the management of excess weight and obesity necessitates more detailed investigation of possible complications it may induce. Therefore, further research is required to develop and study new effective methods for prevention and treatment of complications after surgical treatment of patients with morbid obesity.  

2020 ◽  
Author(s):  
Cristina Fiorani ◽  
Sophie R. Coles ◽  
Myutan Kulendran ◽  
Emma Rose McGlone ◽  
Marcus Reddy ◽  
...  

Abstract Roux-en-Y gastric bypass (RYGB) and sleeve gastrectomy (SG) have been shown to improve metabolic comorbidities as well as quality of life (QoL) in the obese population. The vast majority of previous studies have investigated the metabolic effects of bariatric surgery and there is a dearth of studies examining long-term QoL outcomes post bariatric surgery. The outcomes of 43 patients who underwent bariatric surgery were prospectively assessed, using BAROS questionnaires to quantify QoL and metabolic status pre-operatively, at 1 year and at 8 years. Total weight loss and comorbidity resolution were similar between RYGB and SG. The RYGB cohort experienced greater QoL improvement from baseline and had higher BAROS scores at 8 years. RYGB may provide more substantial and durable long-term benefits as compared to SG.


2018 ◽  
Vol 12 (2) ◽  
pp. 76-79
Author(s):  
V. S. Samoylov ◽  
V. V. Novomlinskiy ◽  
N. А. Malkina

The number of post-bariatric patients is increasing from year to year; any medical specialist can see consequences and sometimes complications of these interventions. The variety of different scenarios associated with such patients is not well studied. Mini-gastric bypass (MGB-OAGB) is a major type of primary or recurrent bariatric surgery in obese patients. Biliary reflux (BR) is one of the most significant late complications of this operation. An increase in the intra-abdominal pressure during pregnancy can lead to the development of BR with its typical clinical symptoms, which may sometimes puzzle an obstetrician-gynecologist. In these cases, there are limitations in using traditional diagnostic approaches and regular medications for conservative treatment of BR. This report presents a clinical observation on a patient who underwent MGB-OAGB as a recurrent bariatric intervention for her morbid obesity. With no signs of gastroesophageal reflux before surgery, soon after it or in the I trimester of pregnancy, a typical clinical picture of BR developed in the II and III trimesters. A complete relief of the BR symptoms after the childbirth (confirmed by gastro-esophago-scopy) suggested a direct connection between the BR and the increase in intra-abdominal pressure during pregnancy.


2010 ◽  
Vol 29 (2) ◽  
pp. E15 ◽  
Author(s):  
Jared M. Pisapia ◽  
Casey H. Halpern ◽  
Noel N. Williams ◽  
Thomas A. Wadden ◽  
Gordon H. Baltuch ◽  
...  

Object Roux-en-Y gastric bypass is the gold standard treatment for morbid obesity, although failure rates may be high, particularly in patients with a BMI > 50 kg/m2. With improved understanding of the neuropsychiatric basis of obesity, deep brain stimulation (DBS) offers a less invasive and reversible alternative to available surgical treatments. In this decision analysis, the authors determined the success rate at which DBS would be equivalent to the two most common bariatric surgeries. Methods Medline searches were performed for studies of laparoscopic adjustable gastric banding (LAGB), laparoscopic Roux-en-Y gastric bypass (LRYGB), and DBS for movement disorders. Bariatric surgery was considered successful if postoperative excess weight loss exceeded 45% at 1-year follow-up. Using complication and success rates from the literature, the authors constructed a decision analysis model for treatment by LAGB, LRYGB, DBS, or no surgical treatment. A sensitivity analysis in which major parameters were systematically varied within their 95% CIs was used. Results Fifteen studies involving 3489 and 3306 cases of LAGB and LRYGB, respectively, and 45 studies involving 2937 cases treated with DBS were included. The operative successes were 0.30 (95% CI 0.247–0.358) for LAGB and 0.968 (95% CI 0.967–0.969) for LRYGB. Sensitivity analysis revealed utility of surgical complications in LRYGB, probability of surgical complications in DBS, and success rate of DBS as having the greatest influence on outcomes. At no values did LAGB result in superior outcomes compared with other treatments. Conclusions Deep brain stimulation must achieve a success rate of 83% to be equivalent to bariatric surgery. This high-threshold success rate is probably due to the reported success rate of LRYGB, despite its higher complication rate (33.4%) compared with DBS (19.4%). The results support further research into the role of DBS for the treatment of obesity.


2019 ◽  
Vol 34 (6) ◽  
pp. 2519-2531 ◽  
Author(s):  
Cristina Vicente Martin ◽  
Luis R. Rabago Torre ◽  
Luis A. Castillo Herrera ◽  
Marisa Arias Rivero ◽  
Miguel Perez Ferrer ◽  
...  

Author(s):  
Antônio Nelson Alencar de Araújo ◽  
Marcos Alexandre Casimiro de Oliveira

Introduction: Morbid obesity is characterized by a state of insulin-resistance and is often associated with metabolic syndrome, increasing overall and cardiovascular mortality. Due to the unsatisfactory results in conventional treatment in specific groups of patients, invasive intervention is an alternative. However, it may be indicated, especially in situations where the patient has severe obesity or morbid obesity. Objective: The present study aims to evaluate the changes in metabolic syndrome parameters after bariatric surgery. Methodology: This is an integrative review of the literature performed through searches in the Scielo, LILACS and PUBMED databases using the following Controlled Health Sciences Descriptors (DeCS): Bariatric Surgery, Gastric Bypass, Obesity and Metabolic Syndrome. The inclusion criteria were: articles in English or Portuguese, text in full, publications in the period from 2009 to 2019 in article format that addressed the theme described. Duplicate publications, articles that did not address the theme after reading the respective abstracts and articles that do not meet the objectives of this study were excluded. Results: According to the analysis of the results, a reduction of 86.1% in the prevalence of metabolic syndrome was observed; 65.3% in arterial hypertension and 84.2% in altered fasting glycemia. A normalization of abdominal circumference in 35.4% of patients, an increase in 35.8% in HDL levels and high triglyceride values may be observed. Among the results obtained, the increase in HDL did not obtain great relevance, as well as the decrease in abdominal circumference. Conclusion: The study showed a positive relationship between bariatric surgery and metabolic syndrome parameters. The results presented were favorable when surgery was associated with a healthy lifestyle and factors that contribute to the effective coping of this condition in most of the cases analyzed. However, multiprofessional follow-up, particularly for medical, nutritional and psychological care, is essential to have a positive impact on the quality of life of these patients.


2009 ◽  
Vol 23 (3) ◽  
pp. 215-216 ◽  
Author(s):  
Maya Doumit ◽  
Gaby Doumit ◽  
Farid M Shamji ◽  
Sylvie Gregoire ◽  
Richard E Seppala

The Roux-en-Y gastric bypass is one of the most common operations for morbid obesity. Although rare, gastropulmonary fistulas are an important complication of this procedure. There is only one recently reported case of this complication. The present report describes the serious nature of this complication in a patient after an uneventful laparoscopic gastric bypass surgery.


Physiology ◽  
2015 ◽  
Vol 30 (1) ◽  
pp. 50-62 ◽  
Author(s):  
Sean Manning ◽  
Andrea Pucci ◽  
Rachel L. Batterham

There has been increasing interest in the role that gut hormones may play in contributing to the physiological changes produced by certain bariatric procedures, such as Roux-en-Y gastric bypass and sleeve gastrectomy. Here, we review the evidence implicating one such gut hormone, glucagon-like peptide-1, as a mediator of the metabolic benefits of these two procedures.


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