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Complications, Health Risks of Biliopancreatic Diversion Gastric Bypass

Health risks of biliopancreatic diversion stomach bypass
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Complications and Risks of Biliopancreatic Diversion Surgery

Judging the complications and risks of stomach bypass treatment of obesity involves an assessment of operative, perioperative, post-operative and long term complications. Also, the risks of gastric bypass must be weighed against the known health risks of severe obesity.

Bypass Complications and Health Risks

  • About 10-20 percent of bypass patients require follow-up operations to correct complications. Abdominal hernias are the most common complication necessitating follow-up surgery.
  • More than one-third of obese patients who have gastric bypass surgery develop gallstones. Gallstones can be prevented but some bariatric surgeons prefer to remove the gallbladder during the initial surgery.
  • Complication rates in the early post-operative period, such as infection, dehiscence, leaks from staple breakdown, stomal stenosis, ulcers and deep thrombo-phlebitis may be as high as ten percent or more. However, the aggregate risk of the most serious complications of gastrointestinal leak and deep venous thrombosis is less than one per cent.
  • Later, other problems may arise and may require corrective surgery.
  • The mortality and morbidity rates of follow-up operations are higher than those of initial bariatric surgery.

Bowel Problems

After all malabsorption surgeries, like biliopancreatic diversion, there is a period of intestinal adaptation during which bowel movements can be liquid and frequent. This bowel complaint, frequently accompanied by bloating, gas and foul smelling stools may reduce with time, but occasionally is a permanent condition.

Nutritional Risks

Malabsorptive operations like biliopancreatic diversion bypass, pose a particular risk for nutritional deficiency. Nearly 30 percent of patients who have stomach bypass surgery develop nutritional deficiencies because they do not adhere to their post-operative guidelines concerning the need for nutritional supplements. This risk of malnutrition stems from the fact that gastric bypasses cause food to bypass the duodenum and jejunum - the places where important minerals like iron and calcium are absorbed into the bloodstream.

Nutritional Conditions

Due to the above, bariatric bypass patients have a high risk of chronic anemia or conditions like osteoporosis and metabolic bone disease. This is why biliopancreatic bypass surgery patients need to take vitamin and mineral nutritional supplements.

Risk of Dumping Syndrome

Biliopancreatic diversion bypass operations may also cause post-operative dumping syndrome. This occurs when the food in the stomach moves too rapidly through the small intestine. Symptoms of dumping include: nausea, sweating, feeling faint, and diarrhea after eating. The risk of dumping syndrome is lower after biliopancreatic diversion with duodenal switch as this procedure maintains the pyloric valve intact.

Rates of Complications of Biliopancreatic Diversion

Protein malnutrition 11.9%
Anemia 35%
Incisional hernia 10%
Intestinal obstruction 1.0%
Stomal ulcer 3.0%
Bone demineralization
- Pre-op 25%
- At 1 - 2 years 29%
- At 3 - 5 years 53%
- At 6 - 10 years 14%
Hemorrhoids 4.3%
Acne 3.5%
Night blindness 3.0%
Operative mortality .04 - 0.8%

[Source: American Society of Bariatric Physicians]

See also:
Biliopancreatic Procedure
Details and Diagram
Weight Loss and Health Benefits
Research

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Laparoscopic or open bariatric surgery, such as gastric banding or bypass is not an easy solution to morbid obesity and weight loss. It is a serious surgical procedure, involving health risks. To produce lasting weight loss it requires a long-term patient commitment to eating a healthy diet and following a regular program of physical exercise. Life-long use of nutritional supplements may also be necessary. So, before deciding, discuss your options fully with your doctor. © 2003-2017 Bariatric-Surgery.Info - Terms - Contact - Information - Resources