Management of complications of the bariatric procedures

Abstract

Obesity is a serious public health problem and represents a global epidemic. It can be classified according to BMI so that patients in class 2 who have obesity related comorbidities or patients in class 3 are considered morbid obese, and this condition is associated with considerable risk of morbidity and mortality. Treatment options for obesity include non-surgical treatment and bariatric surgery. Bariatric surgery is defined as gastrointestinal surgery to help severely obese patients to lose weight. It offers the only realistic chance of long-term weight reduction, and resolution or improvement of co-morbidity for the majority of these patients. Bariatric surgical options are numerous and continue to expand with advancing technology due to the availability of less invasive procedures that provide earlier ambulation after surgery, less postoperative abdominal pain, lower postoperative risks of pneumonia and deep venous thrombosis, decreased length of hospital stay, improved cosmetic appearance, lower risk of postoperative wound complications (including those of infection and hernia development), and an earlier return to societal and job activities. Bariatric surgery has become increasingly accepted among both physicians and patients, however, even with successful weight loss, patients may still develop complications following the surgical procedure. With early recognition and appropriate management, postoperative bariatric complications are generally non-lethal and minor. However, left untreated, they may result in devastating complications. It is therefore critical that all health care professionals responsible for bariatric patients recognize the signs and symptoms, know the proper diagnostic maneuvers, and institute the correct treatment in a timely fashion.