Complications

Description

1

Allergic Reactions

All kinds of allergic reactions are possible, from minor reactions such as a rash to sudden overwhelming reactions that can cause death.

2

Anesthetic Complications

Anesthesia used to put you to sleep for the operation can be associated with a variety of different complications up to and including death.

3

Bleeding

Surgery involves incisions and cutting that can result in bleeding complications, from minor to massive, that can lead to the need for emergency surgery, transfusion or death.

4

Blood Clots

Also called Deep Vein Thrombosis (DVT) and Pulmonary Embolus can sometimes cause death. In the people that have had the Mini-Gastric Bypass 0.08% have developed clots in their legs (Deep Vein Thrombosis) and 0.16% have had a pulmonary embolus.  This is 10 times lower than seen in other series of gastric bypass but it can still happen. I understand that I need to get out of bed the evening after surgery and move and flex my feet and legs to try to help prevent clots from forming in my legs

5

Infection

Including wound infections, bladder infections, pneumonia, skin infections and deep abdominal infections that can sometimes lead to death.

6

Leak

After operation to bypass the stomach the new connections can leak stomach acid, bacteria and digestive enzymes causing a severe abscess and infection.  This can require repeated surgery, and intensive care and even death. In the patients that have had the Mini-Gastric Bypass 1.6% have developed a leak.

7

Narrowing (stricture)

Narrowing (stricture) or ulceration of the connection between the stomach and the small bowel can occur after the operation this can require emergency operation, intensive care and can sometimes lead to death.  To protect your new stomach from ulcers you must never again take aspirin, or aspirin like drugs such as Motrin, Ibuprofen, Naprox, Relafen or other similar drugs.

8

Indigestion, Reflux or Ulcers

The operation can sometimes lead to severe nausea, vomiting, indigestion, abdominal pain, gastritis or ulcers.  This can be severe and can last for days, weeks and possibly even longer.  This is especially likely if you have had previous problems with nausea, abdominal pain or ulcers. Nausea is much more common in women than men.  Women that have been treated with any type of hormone therapy (Premarin, Estrogen or Birth Control Pills) are much more likely to have nausea and vomiting after surgery.

9

Dumping Syndrome

Dumping Syndrome (Symptoms of the dumping syndrome include cardiovascular problems with weakness, sweating, nausea, diarrhea and dizziness) can occur in some patients after gastric bypass. This can be so severe that the surgery may have to be reversed.

10

Bowel Obstruction

Any operation in the abdomen can leave behind scar that can put the patient at risk for later bowel blockage or obstruction.  The bowel can twist, obstruct and even perforate leading to serious complications and even death.

11

Laparoscopic Surgery Risks

Laparoscopic Surgery uses punctures to enter the abdomen and this can to lead to abdominal injury, bleeding and even death.

12

Side Effects of Drugs

All drugs have inherent risks and complications and in some cases can cause a wide variety of side effects, reactions and in some cases including death.

13

Loss of Bodily Function

The performance of surgery and anesthesia can stress the body’s systems leading to a variety of complications including stroke, heart attack, limb loss and other problems related to operation and anesthesia.

14

Risks of Transfusion

Including Hepatitis and Acquired Immune Deficiency Syndrome (AIDS), from the administration of blood and/or blood components.  These illnesses are serious and can be fatal.

15

Hernia

Cuts and incisions in the abdominal wall can lead to hernias after surgery.  Hernias can lead to pain, bowel blockage, obstruction and even perforation and death in some cases.  Treatment of hernias usually requires another operation.

16

Hair Loss

Many patients develop hair loss for a period after operation. When this occurs it usually starts around 3-4 months after surgery and resolves at 7-9 months after operation.   This usually responds to increased oral intake of protein and vitamins but it may be permanent. 

17

Vitamin and Mineral Deficiencies

After gastric bypass there is a malabsorption of many vitamins and minerals.  Patients must take vitamin and mineral supplements forever to protect themselves for these problems.  You also need to have yearly blood tests to measure the blood levels of these vitamins and minerals.  Common deficiencies that can occur after gastric bypass include iron and calcium deficiency, B12 and Folate deficiencies.

This is very important: Patients must take vitamin and mineral supplements forever.  In some cases the deficiencies are so severe that they can lead to nerve and brain damage and the operation must be reversed.

18

Inadequate Weight Loss

WARNING: Remember that you might not lose weight after the operation. 

*There are patients that will fail any type of surgery.  Inadequate weight loss is a risk of all types of weight loss surgery and indeed of all types of weight loss treatment. 

*I recognize that the Mini-Gastric Bypass is not by any means a perfect treatment and that one of the risks that I face is a real possibility of inadequate weight loss following my Mini-Gastric Bypass surgery.

19

Excessive Weight Loss

Some patients sustain excessive weight loss after operation and may require reversal of the bypass to prevent severe malnutrition, nausea or vitamin and mineral deficiencies or death.

20

Complications of Pregnancy

Vitamin and mineral deficiencies can put the newborn babies of gastric bypass mothers at risk.  No pregnancy should occur for the first one to two years after operation.  Gastric Bypass has been shown to cause multiple types of vitamin and mineral deficiencies including: iron, B12, Folate, calcium and many others. Many of these deficiencies have been shown to cause birth defects or are suspected that they could cause birth defects. We also know that many patients who lose weight feel that they are well after surgery and forget to take their vitamins.  Patients must be certain not to miss any of their vitamins if they decide to go ahead with pregnancy later.

21

Unplanned Pregnancy

Warning to women using Oral Contraceptives (Birth Control Pills): More than 80 million women worldwide take "the pill" to prevent pregnancy. Typical failure rates among pill users are as high as 12% to 20% in some surveys.  Other factors have been shown to increase the risk of pill failure: smoking, diarrhea and/or vomiting drug interactions, systemic illness, psychological stress, and menstrual disturbances.  So it is important to recognize that Birth Control Pills may not be an effective method of birth control after the Mini-Gastric Bypass until those factors have resolved. We have found on several occasions that in many cases the hormonal methods of birth control fail after Mini-Gastric Bypass.  Couples need to plan another form of nonhormal birth control for 6-12 months after surgery.  Depo-Provera has also been associated with marked cases of nausea in post MGB patients. An unplanned pregnancy can be one of life's most difficult experiences.

22

Other

Major abdominal surgery, including the Mini-Gastric Bypass, is associated with a large variety of other risks and complications, both recognized and unrecognized that occur both soon after and long after the operation.

23

Depression

Depression and anxiety are common medical illnesses and have been found to be particularly common after operation. 

24

Cancer

Cancer can occur in anyone.  Many cancers are more common in obese as compared to thin patients. Overweight men have a significantly higher rate of prostate cancer. Obese women have higher risks of developing breast cancer and cancer of the uterus and ovaries.  It is expected, but not certain, that with weight loss you will have an overall decrease in your risk of cancer. The Billroth II connection used in the Mini-Gastric Bypass has been used for almost 100 years and is performed over 13,000 times a year in America to connect the stomach to the bowel.  Some studies have suggested that the Billroth II connection used in the Mini-Gastric Bypass can increase the risk of stomach cancer while others do not show this.  The studies showing increase risk of stomach cancer are in Billroth II patients that had the surgery for ulcers and since ulcers can cause an increased risk of stomach cancer it may be the stomach ulcer not the Billroth II that causes some studies to show increased risk of stomach cancer after the Billroth II.  Diet seems to be much more important as a cause of stomach cancer.  Eating processed meats has a much greater effect on increasing stomach cancer risk that the Billroth II.  Conversely fresh fruits and vegetables seem to protect against stomach cancer.  In the end no one knows what will happen in your case and if you are concerned about stomach cancer then you could either 1) Not have the Mini-Gastric Bypass, 2) Have the Mini-Gastric Bypass and avoid processed meats and eat more fresh fruits and vegetables.  In either case stomach cancer is an unlikely event.

25

Death

This is a major and serious operation.  It may lead to death from complications.  There has been a death in the first week after this surgery in one patient.