Surgical risks

Possible postoperative complications can be potentially serious, early or late. In any case, the most important thing is early diagnosis.

Precocious Postoperative Complications

Gastric Bypass
After surgery, vomiting occurs occasionally in 10 - 20% of patients, and is currently caused by eating too fast, not chewing food long enough, consume a lot of food or liquids in a single instant, or eat very dry foods such as chicken breast.
Death is relatively rare with gastric bypass surgery. The risk of global mortality is approximately 1%. It is important to recognize, then, that this is a highly complex surgical procedure in a high-risk patient.
Early postoperative respiratory complications include oxygen insufficiency, atelectasis (partial or total collapse of lung tissue) and pneumonia. All these conditions can reduce walking and do deep breathing exercises and for the same as the previous one. "
The risk of peripheral blood clots and pulmonary embolism is low but potentially serious. This risk of blood clots can be greatly reduced by the use of anticoagulants, and early mobilization.
The obstruction of the intestine is relatively rare. People with scar tissue from previous surgical interventions are more vulnerable to this condition than they have previous surgeries.
Bleeding may require transfusions of blood or blood products and may occur in a small number of patients.
Infections that occur by filtering the junction between the stomach and the intestine are the most serious complications and can threaten the patient's life. The leaks constitute an opening in the stomach or intestine that can leak fluid or food into the abdominal cavity. The location of the filtration is usually at the point where the intestine is sutured to the small pouch of the stomach (called anastomosis) or where the small pouch of the stomach has been separated from the gastric remnant.
Up to 7% of patients and can usually be managed with antibiotics and drainage
Sleeve gastrectomy
They are rare after this surgery, especially when compared with gastric bypass and the gastric band.
The risk of global mortality is less than 1%. It is a surgery with less risk of death than gastric bypass, but the risks depend a lot on the patient in particular.
The risk is similar or slightly less than that of the gastric bypass and its management and prevention are the same.
The frequency of bleeding is low, but may require blood transfusions.
Leaks can occur along the cut line of the stomach. Although these cuts are made with mechanical devices designed for this purpose, there is a potential risk of leakage. Faced with this eventuality, depending on circumstances that are evaluated by the medical team, the need for reoperation is possible to repair the filtration site or eventually fasting for several days until the filtration is closed.
It is an event to which obese patients in general are more predisposed for more surgery. Most often, it is superficial infections at the level of the wounds.
Infections that occur by filtering the junction between the stomach and the intestine are the most serious complications and can potentially threaten the patient's life. The leaks constitute an opening in the stomach or intestine that can leak fluid or food into the abdominal cavity. The location of the filtration is usually at the point where the intestine is sutured to the small pouch of the stomach (called anastomosis) or where the small pouch of the stomach has been separated from the gastric remnant.
It is rare but it can happen due to the proximity of this organ with the part of the stomach to be resected.
Adjustable Gastric Band
It is a potentially serious complication, less frequent than in gastric bypass since surgery is shorter and postoperative recovery and mobilization are faster.
In the immediate postoperative period in a low percentage of cases, patients with extreme obesity and / or who did not correctly perform the preoperative diet may be the case that the band is tight around of the stomach after surgery and does not allow the passage of food. This complication requires delaying the start of oral feeding and staying for several days with intravenous serum.
It is very rare in this surgery since the dissection is minimal.
As in any surgery, there is a risk of infection of the wounds or of the area where the band is placed, it is a rare complication and it is prevented with the administration of antibiotics before surgery .
It is an uncommon complication and the risks decrease with a correct preoperative diet.
It is one of the most serious but rare intraoperative complications, which may contraindicate the placement of the band in that same surgery and may prolong the time of hospitalization.

Late Postoperative Complications

Gastric Bypass
The decrease in nutrient intake with gastric bypass, the formation of the gastric pouch with insufficient production of gastric acid or digestive enzymes and duodenal bypass (the first segment of the intestine thin) and a portion of the jejunum (the second part of the intestine) can produce several nutritional deficiencies of vitamins and minerals. Many of these deficiencies can be corrected by taking a daily vitamin and mineral supplement. However, deficiencies in certain vitamins and minerals such as vitamin B-12, iron, calcium, folates and zinc can still occur. The failure to maintain adequate levels of vitamin B-12, iron, calcium, folate and zinc, is the cause of anemia, bone loss, irreversible nerve damage, with permanent loss of mobility (inability to walk), mental dysfunction, low of immune defenses, and many other problems. It is recommended to replace this deficit through the multivitamin supplementation recommended by your attending physician.
The incisional hernia can occur in 10 - 20% of patients with open procedures and in less than 1% of individuals with laparoscopic surgery. The incisional hernia is a defect in the wall of the abdomen.
Stenosis (narrowing) can occur in up to 10% of patients undergoing gastric bypass. Stenosis is a condition that produces a narrowing or closure that makes it difficult for food to pass from the stomach pouch to the intestine. The passageway can be generally opened without the need for surgery by endoscopic dilatation.
Adjustable Gastric Band
Complications such as disconnection, leakage, rupture, infection, etc. can occur with certain frequency. of the band injection site, in general they are minor complications.
Consists in the erosion of the gastric wall by the band. It is very rare, and forces the extraction of the band.
These are the two most frequent late complications of this surgery. It consists in the first case, in an enlarged stomach that is above the band, in general related to non-compliance with nutritional guidelines and second, it is a migration of the band along the stomach walls towards below, so that the majority of the stomach is above the band and obstructs the passage of the food. Enlargement of the "new stomach" can be treated by deflating the band and retaking the nutritional guidelines in most cases. Sliding requires emergency surgery to reposition the band in position.

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