Complications of bariatric surgery

The epidemic of obesity in the United States has triggered an exponential increase in the number of bariatric procedures performed. This has led to an elevated awareness of the complications of bariatric surgery. Several recent studies have suggested that the mortality rate from bariatric surgery is substantially higher than previously stated, particularly in the elderly and disabled population. As more complications from bariatric surgery occur, general surgeons, primary care doctors and emergency room personnel may be increasingly called upon to diagnose and treat them. This review describes the most commonly seen complications of bariatric surgery including anastomotic leak, thromboembolism, stricture formation, internal hernia, ulcer formation, cholelithiasis, hemorrhage, nutritional and metabolic derangements. Additionally, complications specific to the adjustable gastric band are addressed. The etiology, diagnosis and management of these complications is discussed. The long-term viability of bariatric surgery as a treatment for severe obesity will depend upon the prevention and appropriate treatment of bariatric complications.