Late surgical complications after gastric by-pass: a literature review

Abstract

IntroductionGastric bypass is today the most frequently performed bariatric procedure, but, despite of it, several complications can occur with varied morbimortality. Probably all bariatric surgeons know these complications, but, as bariatric surgery continues to spread, general surgeon must be familiarized to it and its management. Gastric bypass complications can be divided into two groups: early and late complications, taking into account the two weeks period after the surgery. This paper will focus the late ones.MethodLiterature review was carried out using Medline/PubMed, Cochrane Library, SciELO, and additional information on institutional sites of interest crossing the headings: gastric bypass AND complications; follow-up studies AND complications; postoperative complications AND anastomosis, Roux-en-Y; obesity AND postoperative complications. Search language was English.ResultsThere were selected 35 studies that matched the headings. Late complications were considered as: anastomotic strictures, marginal ulceration and gastrogastric fistula.ConclusionKnowledge on strategies on how to reduce the risk and incidence of complications must be acquired, and every surgeon must be familiar with these complications in order to achieve an earlier recognition and perform the best intervention.

Multidisciplinary approach of non-responders after bariatric surgery reduces the indication for revisional surgery: a retrospective cohort study

“…None of the seven patients that underwent this procedure suffered from a complication. Yet, one patient suffered from an ulcerative stenosis at the gastroenterostomy after limb length alteration, which is a frequently reported complication in literature [17].…”

A multidisciplinary approach for non-responders after bariatric surgery: why does it matter?

“…In the context of revisional surgery it is important that the patient is exposed to the risks of major complications [13], as well as that the patients' weight loss may not be sustainable in the long term. Surgery does not resolve the lifestyle and/or behavioral problems that may have contributed to non-response in the rst place [11,[21][22][23].…”

Efficacy of Retrievable Metallic Stent with Fixation String for Benign Stricture after Upper Gastrointestinal Surgery

“…Early anastomotic strictures (within 3 months after the operation) are usually secondary to postoperative edema, while late strictures (more than 3 months after the operation) are related to fibrotic scarring (12). Anastomotic stricture can be treated with fluoroscopy or endoscopy-guided balloon dilatation, covered stent placement, or surgical revision (131819).…”

“…Early anastomotic strictures are usually secondary to edema, whereas late strictures are related with fibrotic scarring (12). Balloon dilatation is regarded as a safe and effective initial treatment for benign strictures (34).…”