Severe complications rare after gastric bypass

Patients who experience complications after undergoing gastric bypass surgery need not worry, as most problems are treatable and do not cause permanent disability. Gastric bypass surgery has become a popular treatment for severe obesity, but the long-term risks have been unclear. Only 1 per cent of the patients have complications classified as severe or leading to any (even temporary) disability. Researchers from the University of California in San Francisco assessed the occurrence of complications in all severely obese patients who underwent open or laparoscopic gastric bypass at their centre from 2003 to 2006. Complications were classified as grade 1, which required only a bedside intervention to treat; grade 2, which required a more involved intervention, but caused no lasting disability; grade 3, which resulted in irreversible deficits and grade 4, which resulted in death. Of the 404 patients included in the study, 72 had gastric bypass performed with the open approach and 332 had the surgery performed laparoscopically. Seventy-four patients (18 per cent) experienced a total of 107 complications. Optimal results of gastric bypass are obtained with proper patient selection and care before and after surgery using a multidisciplinary, experienced team. Grade 1 and 2 complications, which were usually wound-related, were more likely to occur following open rather than laparoscopic gastric bypass. With the open approach, the rates of these complications were around 20 per cent, whereas with the laparoscopic approach, they did not exceed 8 per cent. Four patients (1 per cent) experienced a grade 3 or 4 complication, which occurred with comparable frequency with each surgical approach. Risk factors for complications included diabetes mellitus, a surgeon with limited experience, and the open approach. The results of the study convey that gastric bypass, performed at centres with experienced teams and surgeons and with multidisciplinary care available, is safe and yields the expected benefits of gastric bypass (including) sustained weight loss along with improvement of obesity-associated diseases, such as diabetes and high blood pressure.