Gastric bypass

Risks and complications

The gastric band device

Although there is no doubt that a gastric bypass operation can be both life-transforming and life-saving, the decision to go ahead with surgery is a serious one. You should research the procedure carefully and make sure you have had all your questions answered before deciding to go ahead. You need to feel comfortable with the procedure, the operating surgeon and your provider.

In experienced hands, the operative risks and likelihood of developing long-term complications are relatively small. The early complication rate is approximately 5% (5:100) and the overall mortality rate is very low at around 0.3% (3:1000). It should also be remembered that these incidence rates are based on thousands of patients, many of whom are very large and some of whom will be managing severe health problems, for example uncontrolled diabetics and patients with body weights in excess of 40 stone. For most of the patients we treat in the private sector the risk is much lower. Operative risks include:

  • Haemorrhage (bleeding)
  • Anastomotic and staple line leakage, ulcers or stricture
  • Anaesthetic and drug reactions
  • Deep vein thrombosis / pulmonary embolus
  • Infections
  • Respiratory (lung) problems
  • Visceral and vascular injury
  • Dilatation of the pouch
  • Keyhole reverting to open surgery
  • Death
  • Pain/discomfort
  • Internal hernia
  • Scarring
  • Short term swelling and bruising
  • Seroma and haematoma

We understand that the list of possible complications is long and can cause anxiety but it’s important to remember that the incidence rates are very low. We have a duty to explain the risks to you, so the list is long for the sake of completeness. When providers say little about complications it is wise to be cautious about them as any surgeon can experience complications, it’s the incidence rates that will vary.  Your surgeon will talk to you about the risks of surgery in more detail.

Other considerations

In addition to the complications we have listed there are other considerations that bypass patients should be mindful of when deciding to proceed with surgery.

  • Risk of vitamin & mineral deficiency.
    Lifelong supplementation of vitamins and minerals will be required
  • Lifelong follow-up with regular blood tests is essential.
    We include this for 2 years and advise your GP of the tests that are required for the long term.
  • There is a risk of ‘Dumping syndrome’ – see more on this below

Important: Smoking increases your risk of experiencing a complication

Dumping syndrome

Not all bypass patients will experience this. It is probably due to changes in gut hormones and sugars entering the small bowel from the newly formed stomach pouch. Only minor symptoms are noticed in most patients who experience dumping. Treatment beyond dietary manipulation is only required in a very small minority of patients. Dumping will be discussed at your consultation. Symptoms include:

  • Nausea and vomiting
  • Abdominal pain, cramps
  • Diarrhoea
  • Dizziness, light-headedness and fatigue
  • Bloating, belching
  • Heart palpitations, rapid heart rate

Excess or loose skin following a bypass

Due to the considerable amount of weight that gastric bypass patients typically lose*, it’s possible that you will experience some excess, loose or saggy skin. This most commonly occurs in the abdominal apron, or trunk area. The amount of excess skin you’ll be left with following a gastric bypass operation varies and will depend upon your age and weight before the procedure. Generally, the heavier and older you are, the more likely you are to have extra skin. Younger patients tend not to have as much loose skin due to greater natural skin elasticity.

*Use and Outcomes of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Gastric Bypass: Analysis of the American College of Surgeons NSQIP.J Am Coll Surg. 2015 May;220(5):880-5. doi: 10.1016/j.jamcollsurg.2015.01.059. Epub 2015 Feb 16

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