While all major surgeries involve a certain level of risk, following risks are related to different types of weight loss surgeries. However, it may vary in individual cases.
Deficiency BPD with duodenal switch
Procedure Type - Malabsorptive
Description: Combines a lower level of restriction with a higher degree of malabsorption. Stapling is used to create a sleeve of stomach retaining the natural stomach outlet. The majority of the small intestine is bypassed causing nearly complete malabsorption of food contents.
Results: Studied patients have achieved excess weight loss of 74 percent at one year, 78 percent at two years, 81 percent at three years, 84 percent at four years and 91 percent at five years.
Provides less restriction of food consumed than the other procedures and patients are able to eat larger meals than with restrictive procedures.
Risks: A period of adaption to bowel movements that can be very liquid and frequent - may lessen over time, but may be a lifelong occurrence. Abdominal bloating and malodourous stool gas. Lifelong vitamin supplementing is required
Close lifelong monitoring for protein malnutrition, anaemia and bone disease is recommended Increased risk of gallstone formation. Increased risk for removal of the gallbladder, intestinal irritation and ulcers and pulmonary embolism or respiratory insufficiency.
Biliopancreatic diversion
Procedure Type - Malabsorptive
Description: Approximately 3;4 of the stomach is removed. Restricts food intake and reduces acid output. Small intestine is divided. One end is attached to the stomach pouch to create an alimentary limb. Food moves through alimentary limb with little absorption of food.
Results: Studied patients have achieved excess weight loss of 74 percent at one year, 78 percent at two years, 81 percent at three years, 84 percent at four years and 91 percent at five years.
Provides highest level of malabsorption. Patients are able to eat larger meals than with restrictive procedures.
Risks: Short-term:
A period of adaption to bowel movements that can be very liquid and frequent - may lessen over time, but may be a lifelong occurrence Abdominal bloating and malodourous stool gas. Close lifelong monitoring for protein malnutrition, anaemia and bone disease is recommended. Increased risk for removal of the gallbladder Intestinal irritation and ulcers. Susceptibility to dumping syndrome with ingestion of sweets, high-calorie liquids or dairy products.
Long-term: Lifelong vitamin supplementing is required. Increased risk of gallstone formation.
Laparoscopic adjustable gastric banding
Procedure Type - Restrictive
Description: A band is placed around the upper most part of the stomach separating the stomach into one small and one large portion. Band can be adjusted to increase or decrease restriction. Surgery can be reversed.
Digestion and absorption is normal.
Results: In European studies, mean weight excess loss (EWL) three, four and five years after surgery was 49, 55 and 57 percent respectively.
Risks: Short-term:
Outlet obstruction. May not provide the necessary feeling of having had “enough to eat.” Expansion of the stomach pouch. Nausea and vomiting. Pulmonary embolism or respiratory insufficiency.
Long-term:
Slippage and migration of the band. Leakage of the band. Erosion or migration of the band. Port infection after insertion of band. Increased risk of gall stones and incisional hernia.
Laparoscopic sleeve gastrectomy
Procedure Type - Restrictive
Description: Stapling is used to create a smaller sleeve of stomach. Restricts food intake. Retains the natural stomach outlet. Digestion and absorption is normal.
Results: Patients have achieved excess weight loss of 50-80 percent two to three years after surgery’- 9, 10, 11. Reduced risk of dumping syndrome.
Risks: Short-term:
Leaky staple lines. Injury to pancreas and spleen by the surgeon or his instruments during the operation. Excessive narrowing of the stomach (gastric stenosis). Pulmonary embolism or respiratory insufficiency.
Long-term:
Increased risk of gall stones. Incisional hernia.
Gastric bypass roux-en-y
Procedure Type - Combined Restrictive/Malabsorptive
Description: Stapling is used to create a smaller, upper stomach pouch which restricts the amount of food able to be consumed. A portion of small bowel is bypassed thus delaying food from mixing with digestive juices to avoid complete calorie absorption.
Results: Average of 77 percent of excess body weight loss one year after surgery. Studies show that after 10 to 14 years, patients have maintained 60 percent of excess body weight loss.
A study of 500 patients showed that 96 percent of certain associated health conditions studied were improved or resolved, including back pain, sleep apnoa, high blood pressure, Type II diabetes and depression.
In most cases patients report an early sense of fullness, combined with a sense of satisfaction, that reduces the desire to eat.
Greater total weight loss compared to restrictive procedures.
Risks: Short-term:
Nausea and sickness. Vitamin B12 deficiency. Leaky connection between stomach and intestine or two sections of the intestine (anastomotic insufficiency), constipation and diarrhoea.
Long-term: Protein, mineral and vitamin deficiency. Chronic anaemia due to vitamin B12 and Incisional hernia. Intestinal occlusion. Narrowing at one of the surgical connection points and Increased risk of gall stones.
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