Wednesday, March 30, 2011

Mortality can increase by complications of gastric bypass surgery

Complications of gastric bypass

A major operation involving a risk of complications, side effects that increase risk, hospital stay, and mortality . Few complications are very common to all abdominal surgeries , while others are specific to obesity surgery. Individuals who choose weight loss gastric surgery should know about these type of risks factors or complications. In experienced surgeon's hand , the general complication rate for this type of surgery varies from 7 percent for laparoscopic procedures to 14.5 percent for operations through open cuts during 30 days after weight loss gastric surgery. Mortality in this study was 0 percent to 401 cases by laparoscopy and 0.6 percent in 955 open type of surgery . Corresponding mortality rates 30days mortality after surgery of 0.11 percent and the 90 day mortality after of 0.3 percent was registered in the U.S. centres of excellence, results from gastric weight loss surgery 33,117 in 106 centres.

Mortality is affected by complications of gastric bypass surgery, which in turn are affected by pre-existing risk factors such as the degree of obesity or weight loss, cardiac disease, obstructive sleep apnea, diabetes mellitus, and prior history of pulmonary embolism. Also affected by the experience of the gastric bypass surgeon the learning curve for laparoscopic gastric surgery is estimated at 100 cases. Unfortunately, the way of expert becomes a more expert in dealing with difficulties is to address these problems over time.

Anastomotic leakage
Surgical anastomosis is a connection between the stomach and intestine, or between two parts of the intestine. A surgeon attempts to make a watertight connection by linking the two bodies, either with sutures or staples, or what actually makes a hole in the wall of the intestine. The surgeon is based on the body's healing power and its ability to make a seal like a self-sealing tire, to be operated successfully. If this seal is formed, for whatever reason, the fluid in the gastrointestinal tract can penetrate into the sterile abdominal cavity and lead to infection and formation of abscess . Anastomotic leakage may occur in approximately 2percent of gastric bypass procedures, usually in the stomach to the intestine. Sometimes the leaks can be treated with antibiotics, and sometimes it needs re-surgery immediately. Usually, the best way to get back to work if an infection may not be completely controlled immediately.

Anastomotic stricture
As the healing of anastomosis , it forms a scar tissue, which naturally tend to contract by time, making the opening more smaller . This is known as a narrowing. Normally, the passage of food in a tense anastomosis keep open, but if the process of inflammation and healing faster than the stretching process, scarring can make the opening so small that even liquids can not pass through. The solution is a procedure known as gastroendoscopy and extension of the connection by inflating a balloon inside. Sometimes this type of manipulation may be necessary to place more than once to achieve a last correction.

Anastomotic ulcer
Anastomotic ulceration occurs in 1-16 percent of patients .

The possible causes of ulcers are :
  • Restricted blood supply to the anastomosis (In comparison with the supply of blood available in the original stomach ).
  • Gastric acid.
  • Helicobacter pylori.
  • Anastomotic tension.
  • Cigarette smoking.
  • Non-steroidal anti-inflammatory drug use.