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Although relatively infrequent, severe complications after gastric bypass surgery can occur. Not all complications are life threatening, however, some complications can be. Complications occurring within the first 30 days after the procedure are considered "early" complications. Those complications occuring after the first 30 days are considered "late" complications. The following is a brief description of the most common complications after gastric bypass surgery, both early and late. There may be other complications that can occur following this operation.

Early Complications
Staple line leak: One of the most feared complications after gastric bypass surgery is a leak at the connection between the pouch and the small intestine. This staple line disruption can also occur at other sites where the stomach and small intestine have been divided. The incidence of this complication is considered to be around 1% nationally. In some instances you may have to undergo an additional surgical procedure(s) to correct this problem.

Deep Vein Thombosis and Pulmonary Embolus: This is a rare but dangerous complication. A blood clot can form in your leg or in your pelvic veins (deep vein thrombosis) and can travel to your lungs (pulmonary embolism). This can place a significant strain on your heart and lungs endangering your life.

Cardiac Problems (Heart Attack, Arrythmia, Congestive Heart Failure): Severe cardiac problems can occur. We will make every effort to assess your cardiac condition prior to the surgical procedure.

Lung Problems (Respiratory Insufficiency or Pneumonia): Lung complications may occur after the surgery necessitating the use of a ventilator. This can lengthen your hospital stay and your recovery.

Injuries to other Intra-Abdominal Organs: As with all surgical procedures, injuries to other intra-abdominal organs can occur. Your surgeon will attend to them as needed. *Removal of the spleen is necessary in about 0.3% of patients to control operative bleeding.

Hemorrhage: Bleeding can occur from staple lines or blood vessels during the procedure or in the early post-operative period. This may require the transfusion of blood products. In some instances you may need an operative intervention to control the blood loss.

Infections: Infections can develop either at incision sites or within the abdominal cavity and may require further procedures or the possible need for another operation. Infections of the urinary tract and intravenous line sites can also occur but are usually managed with oral antibiotics and discontinuing the IV or bladder catheter.

Dehiscence: is complete breakdown of the surgical incision (associated with open surgery only) and requires another operation to repair.

Complications due to Anesthesia and Medications: Your surgeon and anesthesiologist will take a complete history to ensure there are no adverse reactions to medications as a result of a known allergy. Despite this, there are rare occassions when a patient has an adverse reaction to an anesthetic or medication.

Conversion to an "Open" Operation: Although this is not a true complication, it is important for patients to understand that it may be necessary to convert to an open operation. Common reasons for converting to an open operation are bleeding, dense scar tissue, difficulty working against a very thick abdominal wall or difficult anatomy. Your surgeon will convert to an open operation to ensure that you get the best and safest operation possible.

Death: The risk of dying is less than 0.5%. The most common cause of death is from a massive pulmonary embolism. Other casues can be related to problems with the heart, lungs or kidneys.

Late Complications
Gastroenterostomy stenosis: The connection between the stomach pouch and the small intestine is made a certain size to restrict the rapid emptying of your new stomach. In some patients, excessive scarring can occur at this site and will shrink this opening further. The patient usually complains of inability to tolerate solid foods and may have retching or vomiting. This complication is managed by performing an endoscopic dilation (enlarging the opening via a camera placed through the mouth). It may require multiple dilatations at different times to manage the problem.

Marginal ulcers: Marginal ulcers are erosions that develop at the connection between the small intestine and stomach pouch. Patients usually complain of pain, nausea and occasional vomiting blood. Treatment usually consists of antacid medications, however, refractory cases may require re-operation and reconstruction of the connection between the stomach and small intestine.

Internal Hernias: These complications are decreasing as bariatric surgeons have modified the surgical techniques accordingly. Patients usually complain of diffuse crampy, abdominal pain after meals that may or may not improve with vomiting. If they do occur, you will require a surgical intervention to correct it.

Small Bowel Obstruction: After any type of surgery adhesions will develop. Adhesions are scar tissue that forms inside the abdominal cavity. Adhesions are the most common cause of small bowel obstruction. The risk of developing dense adhesions is substantially higher if the procedure is performed "open".

Malnutrition: This procedure causes malabsorption of the food and nutrients you eat. Certain vitamins (B1, B12, calcium, iron, folate, etc.) may not be absorbed well enough for you to meet the recommended US daily requirements. For this reason, we recommend you take a multivitamin, calcium, vitamin B12 and possibly iron for the rest of your life. You will be required to undergo annual blood work to evaluate for possible nutritional deficiencies.

Dumping Syndrome: Although dumping is not dangerous, it is frightening to the uneducated patient. Short periods of dizziness, sweating, nausea, vomiting, diarrhea and palpitations can occur. This phenomenon is almost always cause by eating food or drink high in sugar. Changes in dietary habits are usually all that is needed to prevent these sequelae.

Diarrhea: Diarrhea can occur immediately after surgery but usually subsides. Chronic diarrhea is not a common side effect of this procedure.

Kidney/Bladder Stones: Kidney stones and bladder stones can develop after gastric bypass surgery. It is extremely important to maintain good hydration by drinking plenty of fluids.

Hair Loss: Some patients report some form of temporary hair loss, which is believed to be due to a reduced and insufficient post-operative intake of protein. Again, patients need to follow post-operative instructions meticulously. The hair loss almost always returns within one year.

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