Risks, Complications, and Long-Term Success After Surgery
On this week’s episode of Bariatric Friday, Kemal Erkan and Dr. Isaias Irgau meet to discuss risks, complications, and long-term success after surgery. Every major operation is not without its risks, but they can be prevented and managed with proper care. Bariatric surgery is a significant undertaking, but it is not dangerous. Morbid obesity, on the other hand, is a much more dangerous condition if left untreated. The risk of bariatric surgery is comparable to gallbladder removal or joint removal surgery, which are commonly done procedures in frail patients. The risk of death from bariatric surgery is below 1 in every 1,000 in high quality centers. Dr. Irgau emphasizes that the conditions we should really be worried about are type II diabetes, sleep apnea, high blood pressure, and other chronic diseases.
Most complications happen within the first 30 days. Some of the most common complications include bleeding, formation of blood clots, leaks, and dehydration from the stomach being quite small. However, most of these are preventable. To mitigate risk, patients are encouraged to walk early after surgery and are also given medications to prevent clots. Laparoscopic surgery is also much more effective in controlling bleeding and decreasing that risk, Dr. Irgau says. It is also crucial that patients are notifying their surgeons of any concerning symptoms as soon as possible. The earlier leaks are caught, the better the outcome.
In terms of deficiencies after surgery, the most common ones to look out for are iron deficiency, vitamin D deficiency, and vitamin B12 deficiency. These are not surgical failures; patients just need to make sure they are following up with their care team and getting their blood work done. Such deficiencies are expected, but following protocols and taking supplements can help prevent undesirable outcomes.
Some other issues that can occur from bariatric surgery are food intolerance, acid reflux, dumping syndrome, nausea and vomiting, or bowel blockage. Because of the changes made to the digestive system, it is important that patients are not returning to old habits like consuming excessive refined sugars or alcohol. Patients are also advised not to smoke after the procedure, as this can result in painful ulcers and other potential complications.
Another topic that Erkan brings up is that of weight regain. While some may see weight regain as a failure of bariatric surgery, it actually is not. Dr. Irgau even goes on to say that some weight regain is expected in the long-term. It is only when there is significant weight regain that we may see it as an issue to be addressed. This can still be remedied with reestablishment of good habits. Patients should reach out when they are struggling, and Dr. Irgau acknowledges that things happen. People can go through stressful life events that trigger weight regain. Rather than hiding in shame, Dr. Irgau emphasizes that bariatric surgeons want patients to reach out for help as soon as possible. This is ultimately to help each patient maintain long-term success.