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Complications of antiobesity surgery

Nature Clinical Practice Gastroenterology & Hepatology volume 4, pages 138–147 (2007)Cite this article

Abstract

Bariatric surgery is an effective long-term treatment for patients who suffer from morbid obesity, the incidence of which is increasing in North America. Laparoscopic gastric bypass and laparoscopic adjustable gastric band placement are the two commonly performed bariatric procedures. This article discusses the indications for bariatric surgery and the early and late complications associated with these two procedures. Laparoscopic biliopancreatic diversion and laparoscopic sleeve gastrectomy are also briefly discussed.

Key Points

  • Bariatric surgery is an effective long-term treatment for morbidly obese patients (i.e. a BMI >40 mg/kg2) who have failed nonsurgical attempts to lose weight

  • At present, the two bariatric operations most commonly performed are laparoscopic gastric bypass and laparoscopic adjustable silicone gastric band placement

  • Complications of laparoscopic Roux-en-Y gastric bypass include anastomotic leak, bowel obstruction, gastrointestinal hemorrhage, wound infection, pulmonary embolism, anastomotic stricture, incisional hernia, and marginal ulceration

  • Complications of laparoscopic adjustable silicone gastric band placement include gastric perforation, stoma obstruction, band slippage, access port infection, port and tubing problems, and band erosion

  • Complications occur infrequently when surgery is performed by experienced surgeons who work in centers with the necessary equipment and personnel

  • Until there have been prospective, randomized trials to compare the outcomes of laparoscopic gastric bypass with laparoscopic adjustable silicone gastric band placement, the basis of selection between the available operations will remain up to the surgeon and the patient

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Figure 1: Laparoscopic Roux-en-Y gastric bypass
Figure 2: Laparoscopic adjustable silicone gastric band placement

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Authors and Affiliations

  1. NT Nguyen is an Associate Professor of Clinical Surgery and Chief of the Division of Gastrointestinal Surgery, and SE Wilson is a Professor of Surgery, University of California, Irvine Medical Center, Orange, CA, USA.,

    Ninh T Nguyen & Samuel E Wilson

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  1. Ninh T Nguyen
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  2. Samuel E Wilson
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Correspondence to Ninh T Nguyen.

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The authors declare no competing financial interests.

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Nguyen, N., Wilson, S. Complications of antiobesity surgery. Nat Rev Gastroenterol Hepatol 4, 138–147 (2007). https://doi.org/10.1038/ncpgasthep0734

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  • DOI: https://doi.org/10.1038/ncpgasthep0734

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