Did you know that there are around two dozen different risks that every gastric surgery patient should be aware of before opting for the procedure?
Even though your surgeon will explain all potential bariatric surgery risks and complications, it’s always a good idea to do your research beforehand so that you could be more mentally prepared for the consultation.
Today, all gastric surgeries are safe compared to what they were decades ago, so you can have your heart at ease when going to the operation. However, there are no guarantees, and you can never be 100% ready for anything.
There are three main timeframes to look at when it comes to risks and complications regarding gastric surgery. These are:
- Risks associated with the surgical procedure itself
- Post-operative short term risks
- Post-operative long term risks
Let’s have a closer look together at what you should be prepared for in each stage of your weight-loss journey.
Risks Associated With The Surgical Procedure Itself
As mentioned before, the most common bariatric surgeries are all very safe, so only a few things can go wrong in rare cases. Some of the few risks related to the surgical procedure are:
- Adverse reactions to anesthesia
- Excessive bleeding
- Blood clots
- Lung or breathing problems
Understandably, the risk of death sounds terrifying. Fortunately, the experience has shown that the initial procedure-related mortality rate for all common weight-loss surgeries is only 0.14% or less.
Post-Operative Short Term Risks
After the gastric surgery is completed, the patient starts with a post-operative treatment and recovery plan. Even if the patient follows all the guidelines, there are few risks and complications independent of them. These post-operative short term complications include:
- Leaks – patients who have a body mass index (BMI) greater than > 50 kg/m2, have a dysmetabolic syndrome X, or those undergoing revisional bariatric operations are most at risk for experiencing leaks.
One of the main symptoms and most worrisome signs that should be addressed quickly are tachycardia (an abnormally rapid heart rate, >120 beats per minute (bpm)), fever, dyspnea, and abdominal pain. The symptoms usually emerge within three days after the operation.
- Stenosis – a condition, also known as a stricture, where the stomach pouch and the small intestine may narrow. Stenosis causes patients to report the sensation of stuck food and the urge to regurgitate.
- Bleeding – post-operative bleeding that requires intervention occurs in up to 11% of cases in both the Roux-en-Y gastric bypass and sleeve gastrectomy.
- Venous thromboembolism – one of the leading causes of mortality after gastric procedures. Typically occurs three weeks after the procedure. The most prone to this condition are patients undergoing a revisional operation, those whose BMI is greater than >50 kg/m2, and those whose surgery lasted more than 4 hours.
- Vomiting – food intolerance and vomiting are relatively common early on after gastric surgeries due to the gastrojejunostomy becoming too narrow while it tries to heal. Until the upper join remodels back to normal after around six months, it may be necessary to rewind to a liquid diet and soft foods during that time.
Post-Operative Long Term Risks
Now, let’s dive a bit deeper into the longer-term risks and complications. Still, it’s essential to keep in mind that they all don’t apply to every gastric surgery out there, and some risks and complications are not included in the list because they apply to only one specific procedure. You can read more specifically about every procedure from here.
Long-term risks may include:
- Dumping syndrome – certain types of foods (mostly sweet or high-fat foods, especially when eating and drinking at the same time) can rush through the small intestine too fast, drawing fluid with it. This may trigger discomfort, weakness, nausea, dizziness, and diarrhea. Fortunately, only 1 in 10 people experience it.
- Ulcers – approximately 15% of gastric bypass patients experience gastric ulcers. It’s diagnosed by endoscopy, and the treatment lasts for three months.
- Gallstones – a common problem among obese people, mainly because of high cholesterol levels or high fatty deposits. Around 25% of all obese people suffer from gallstones.
- Hernia – this defect, obstruction, or hole in the stomach or groin lining usually develops in up to 4.5% of gastric surgery patients.
- Malnutrition – since most gastric surgeries restrict the food amounts you can eat, some patients may experience malnutrition because their bodies don’t get enough micro- (vitamins, minerals) or macroelements (fat, carbohydrates, protein) anymore.
Due to vitamin and nutrient deficiencies, supplements and vitamins must be taken daily (especially vitamins B12 and D, iron, calcium, and other trace elements).
- Supplements and vitamins must be taken dailyAcid reflux – a condition when stomach acids leak into the esophagus, causing an unpleasant burning feeling known as acid reflux or heartburn (typically after gastric sleeve procedure).
- Bowel obstruction – operations in the abdomen area create a possibility for forming scar tissue that may cause a blockage of the intestine. Occurs in about 3% of gastric bypass patients.
- Low blood sugar – also known as hypoglycemia, doesn’t usually begin until more than one year after the surgery. It happens due to metabolic changes that cause excess insulin production.
- Revision surgery – about 10-20% of the patients, opt for second revision surgery. Reasons for this may vary:
- in the case of gastric sleeve, the sleeve created to take the place of the stomach may be simply too big;
- in the case of gastric band procedure, the band may sometimes slip;
- the surgeon’s technique might not suit the patient.
However, typically the gastric surgery failure comes back to the patient. Whether they didn’t strictly follow the diet and exercise guidelines they were assigned to, or the necessary lifestyle changes lasted only for a while.
As you can see, there are around 20 main risks and complications that every gastric surgery patient should be aware of and consider when weighing the pros and cons of weight-loss surgery. Now that the homework is done get in touch with our team of experts to determine the best possible roadmap and weight-loss surgery for you!