Outcomes of Bariatric Surgery
Bariatric procedures work by either restricting the volume of food consumed at one time or preventing the absorption of the calories. Some procedures have both effects. The most popular procedures include the Roux-en-Y gastric bypass (RYGB), Laparoscopic adjustable gastric banding (LAGB), and the Sleeve gastrectomy (SG). Other less invasive procedures are being developed.
The weight loss at 2 years ranges from 50-70% and is dependent on which procedure is performed. The RYGB is the most invasive and effective while the LAGB is the least. Individuals can also expect partial or complete resolution of their obesity related medical conditions such as hypertension, diabetes, elevated cholesterol and obstructive sleep apnea.
Early complications from these procedures include bowel obstruction, leaks from the intestinal anastomosis sites, infections, injury to internal organs, thromboembolic events, return to surgery and breathing difficulties. Heart attacks and strokes can also occur due to the stress of the surgery. There are many factors that affect the risks of these outcomes including skill of surgeon, individual factors (obesity increases the risks of all these problems) and adherence to perioperative protocols designed to decrease these events.
Long-term problems include dumping syndrome, intestinal ulcers, gallstones, kidney stones, stenosis at the stomach outlet, depression and abdominal pain. The possibility of regaining all of the weight also exists. Extensive pre-surgical counselling and follow up after surgery is designed to prepare individuals for these outcomes and provide interventions as needed. In addition, behavioral modifications should be discussed before the surgery and individuals should plan to adhere to recommended diet and exercise to maintain a normal weight.
The risk of adverse events and mortality (death) are much lower now than in the past. The 30-day mortality rate is less than 1% and the majority are due to pulmonary embolism, cardiac events such as an infarction, respiratory failure and sepsis. The overall adverse event rate is approximately 4.1% but varies by procedure. The open RYGB has a rate of 7.3% while the laparoscopic RGYB is 5.5% and the LAGB is 3%. These risks are low and for some are worth it to avoid the increased morbidity and mortality due to obesity.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!
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