nutritional disorders
Metabolic and Bariatric Surgery
Risks of Metabolic and Bariatric Surgery
Perioperative risks are lowest when metabolic and bariatric surgery is done in an accredited center. Complications include Gastric and/or anastomotic leaks (in 1 to 3%) Pulmonary complications (eg, ventilator dependence, pneumonia, Pulmonary Embolism (PE) ) Acute Myocardial Infarction (MI) None Wound infection Incisional hernia Intestinal Obstruction None Gastrointestinal bleeding Ventral hernia Deep Venous Thrombosis (DVT) None Pulmonary Embolism (PE) None These complications can cause significant morbidity, prolong hospitalization, and increase costs. Tachycardia may be the only early sign of anastomotic leak. Later problems may include prolonged nausea and vomiting secondary to Intestinal Obstruction and anastomotic stenosis. Nutritional deficiencies (eg, Protein-Energy Undernutrition (PEU) , Patients may have symptoms of reflux, especially after sleeve gastrectomy. During rapid weight loss, Cholelithiasis (often symptomatic), Incidence of psychologic disorders such as Depressive Disorders is increased in patients having metabolic and bariatric surgery. A 2016 meta-analysis confirmed this increase in preoperative depression and reported a postoperative decrease in the prevalence and severity of depression ( Eating habits may be disordered. Adjusting to new eating habits can be difficult. 1.Dawes AJ, Maggard-Gibbons M, Maher AR, et al: Mental health conditions among patients seeking and undergoing bariatric surgery: A meta-analysis.JAMA315 (2):150–163, 2016. doi: 10.1001/jama.2015.18118 2.Castaneda D, Popov VB, Wander P, et al:Risk of suicide and self-harm is increased after bariatric surgery—A systematic review and meta-analysis.Obes Surg29 (1):322–333, 2019. doi: 10.1007/s11695-018-3493-4 3.Heinberg LJ, Ashton K, Coughlin J: Alcohol and bariatric surgery: review and suggested recommendations for assessment and management.Surg Obes Relat Dis8 (3):357-363, 2012. doi: 10.1016/j.soard.2012.01.016 