Laparoscopic Sleeve Gastrectomy
Sleeve Gastrectomy :: Procedure Guide :: Risks and Complications :: Post Operative Instructions
Risks and Complications
Risks, complications and adverse events you need to know about:
All surgical procedures have risks. When you decide on a procedure, you should know what the risks are. Talk with your surgeon in detail about all the risks and complications that might arise. Then you will have the information you need to make a decision.
What are the risks?
Any surgical procedure, laparoscopic or open, requires the acceptance of some risk in order to gain the benefits sought from the operation. There are many risks associated with this surgery including those associated with obesity, history of embolism, diabetes, high blood pressure, heart disease, lung disease or prior abdominal surgery, especially prior surgery on the stomach. The more common risks include: infection, bleeding, nerve injury, blood clots, heart attack, allergic reactions, and pneumonia. These risks can be serious and possibly fatal. The administration of anesthesia also involves risks, most importantly the rare risk of reaction to medications causing death.
Specific risks of Sleeve Gastrectomy Surgery
- spleen or liver damage (sometimes requiring spleen removal)
- damage to major blood vessels
- blood clots in legs or lungs
- stomach leak
- stomach stricture
Note: Laparoscopic surgery is not always possible. The surgeon may need to switch to an “open” method due to some of the reasons mentioned here.
What are the possible complications?
Patients can experience complications after surgery. Most complications are not serious but some may require hospitalization and/or re-operation. Some of these complications may include:
- Significant bleeding/Need for transfusion
- Stomach Leak
- Ulcer and/or Outlet Obstruction
- Stomach Stricture
- Stomach, Spleen and/or other Organ Injury
- Hematemesis (vomiting of blood)
- Infection/Abscess Formation
- Vitamin & Mineral Deficiencies
- Wound Problems (Infection, Hernia)
- Gallbladder Problems
- Weight Regain
- Nausea, Vomiting and/or Gas Bloating
- Blood Clots in the Veins (DVT)
- Pulmonary Embolism
- Respiratory Failure
Long Term Complications
Long term complications with bariatric surgeries have been low.
- The most frequent late complication is weight gain due to enlargement of the pouch, enlargement of the outlet, and last, but not least, patient non-compliance.
- The development of gallstones is related to the rapid and significant amount of weight loss and therefore is highest in the first six months after surgery. Gallstones are not a complication of surgery as such, but rather a complication of rapid weight loss. Obese persons have a very high rate of gallstone formation compared to normal weight persons, mainly because of the many diet/weight loss episodes that obese persons undergo. By age 50, nearly 50% of morbidly obese women have developed gallstones.
- Bowel obstruction due to a blockage from adhesions (scar tissue) can occur after any abdominal operation.
- Stomal ulcer may develop after bariatric surgery. Patients who use non-steroid anti-inflammatory drugs (NSAID) such as ibuprofen, Aleve®, etc. and smokers have a even higher incidence of ulcers. It can be treated with the same kind of drugs that are currently so popular for the treatment of duodenal and stomach ulcers. Only rarely is surgery required as treatment. Be aware that an untreated stomal ulcer may lead to perforation.
Iron deficiency anemia is a complication of significance in the long term. It is almost always preventable. It is not difficult to treat, but must be recognized in order for it to be treated. This is one of the important reasons for long term follow-up.
Be sure to ask your surgeon about these possible risks and complications and any of the medical terms that you don't understand.