Obesity risks add to complications of gastric bypass

December 01, 2003

CHICAGO -- The same health risks that make morbidly obese patients eligible for gastric bypass surgery also leave them susceptible to complications during and after the procedure, according to a five-year imaging study led by a Duke University Medical Center radiologist.

The study followed patients at the University Hospitals of Cleveland after Roux-en-Y gastric bypass surgery, the most popular surgical procedure to aid weight loss in severely obese patients. The surgery involves stapling the upper stomach to create a small pouch that is then attached to the small intestine, thereby reducing stomach capacity and the intestine's ability to absorb nutrients.

Among the 335 patients that participated in the study, radiological imaging revealed 57 complications from the surgeries -- many of them multiple problems in the same patients -- including suture tears and leaks, pulmonary embolism, pneumonia and infection.

"Severely obese patients are at high risk for any type of surgery because of other conditions related to their weight," said Duke radiologist Elmar Merkle, M.D., formerly of the University Hospitals of Cleveland where the study was conducted. "In addition, there is a wide spectrum of procedure-specific complications following Roux-en-Y gastric bypass."

Merkle presented the findings today (Dec. 1, 2003) at the 89th Scientific Assembly and Annual Meeting of the Radiological Society of North America.

The results emphasize that the procedure should be a last resort after all other interventions, such as diet and exercise, have been attempted, said Merkle. The findings also highlight the importance of radiological imaging in diagnosing surgical complications in severely obese patients following gastric bypass, he added.

The researchers reported eight cases of leaks from the stomach into the surrounding abdominal cavity and five instances of staple line disruption in the stomach, complications specific to Roux-en-Y. They also observed three incidents of pulmonary embolism, two cases of pneumonia, and single cases of severe infection and open abdominal wound disruption -- all complications that are prevalent among severely overweight patients undergoing any surgical procedure. Within 30 days of the surgery, 17 patients were readmitted to the hospital.

"This operation should not be considered a cosmetic procedure," Merkle said. "People need to be aware of the potential complications of gastric bypass surgery and treat it as a last option after other less invasive interventions have been tried."

In addition to its complications, the procedure also requires patients to undergo major lifestyle changes, he said. Following the surgery, patients must restrict their eating habits and rely on vitamin supplements for adequate nutrition.

According to the American Society for Bariatric Surgery, 63,000 people had gastric bypass surgery in the U.S. in 2002. That number is expected to increase to 100,000 this year. The National Institutes of Health guidelines state that patients who are at least 100 pounds overweight are eligible for the surgery. Patients who are less than 100 pounds overweight may also be considered based on other life-threatening conditions related to obesity, such as type 2 diabetes or cardiopulmonary problems.

Co-authors of the study were Thomas Stellato, M.D., Cathleen Crouse, Peter Hallowell, M.D., and Dean Akira Nakamoto, M.D., all of the University Hospitals of Cleveland.
-end-


Duke University Medical Center

Related Gastric Bypass Articles from Brightsurf:

Strict diet explains metabolic effect of gastric bypass surgery
In many studies, bariatric surgery has been highlighted as an almost magical method for weight loss and reversing type 2 diabetes.

More interventions follow gastric bypass than gastric sleeve, large study shows
A study involving tens of thousands of bariatric surgery patients found that gastric bypass patients were significantly more likely than gastric sleeve patients to end up back in the hospital in the years following surgery.

Comparing future risks associated with gastric bypass and gastric sleeve surgery
Research from the Harvard Pilgrim Health Care Institute finds that gastric bypass is associated with a higher risk of additional operations or other invasive procedures, compared to a gastric sleeve procedure.

Gastric bypass surgery may benefit muscle strength more than previously thought
Gastric bypass surgery improves relative muscle strength and physical performance in people with obesity, according to a study published in the Endocrine Society's Journal of Clinical Endocrinology & Metabolism.

Race plays role in regaining weight after gastric bypass surgery
African Americans and Hispanic Americans who have undergone Roux-en-Y gastric bypass (RYGB) are at greater risk to regain weight as compared to Caucasians.

Gastric bypass surgery associated with greater weight loss in adults
Adults with severe obesity had greater initial and sustained weight loss with gastric bypass surgery than either sleeve gastrectomy or adjustable gastric banding, according to a new study published today in the Annals of Internal Medicine.

Thirty percent increase in risk of fracture after gastric bypass
A study published in the Journal of Bone and Mineral Research shows that the risk of fractures increases by about 30 percent after a gastric bypass operation.

Gastric bypass surgery can give better control for diabetes and obesity than lifestyle modification
Patients treated with a form of bariatric surgery did significantly better than patients provided with an intensive diabetes and weight management program.

Morbid obesity: Gastric bypass and sleeve gastrectomy are comparable
In Switzerland, 5,500 operations to combat morbid obesity are conducted every year.

Coming a step closer to understanding how gastric bypass works
A study by a team of researchers at the Massachusetts General Hospital Center for Engineering in Medicine (MGH-CEM) and Shriners Hospital for Children has made a technological advancement toward accelerating the discovery of drug targets for obesity, type II diabetes and other metabolic diseases.

Read More: Gastric Bypass News and Gastric Bypass Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.