AR
SLEEVE GASTRECTOMY,Gastric bypass






Sleeve Gastrectomy

General
  • Hospital stay 1-2 days
  • Recovery 1-2 weeks Contraindications
    1. Poor surgical candidates
    2. Sever psychiatric disorder
    3. Intolerance to general anesthesia
    4. Pregnancy
    5. Drug or alcohol addiction
    6. Untreated or sever esophagitis
    7. Barrett›s esophagus
    8. Sever gastroparesis
    9. Achalasia
    10. Previous gastrectomy
  • Sometimes used as staged approach to gastric by-pass
    • Potential acute complications
  • Postoperative complications are rare
  • Hemorrhage
  • Anastomotic staple line leak
  • Deep vein thrombosis
  • Pulmonary emboli
  • Dehydration
  • Death
    • Potential chronic complications
  • Weight regain
  • Marginal ulcer
  • Dumping syndrome with reactive hypoglycemia
  • Luminal stenosis (stomal narrowing)
  • Anastomotic staple line leak
  • Fistula formation
  • Iron deficiency
  • Protein malnutrition
  • Other nutritional and mineral deficiencies (vitamins A, C, D, E, B and K, folate, zinc, magnesium, thiamine)
  • Anemia (often related to mineral and nutrition deficiencies)
  • Neuropathies (resulting from nutritional deficiencies)
  • Osteoporosis (often caused by calcium deficiencies and chronically elevated parathyroid hormone levels)
  • Potential need to re-operate

    • Laparoscopic adjustable gastric banding

    General
  • Outpatient procedure
  • Recovery usually one week
  • Contraindications
    1. Poor surgical candidates
    2. Sever psychiatric disorder
    3. Intolerance to general anesthesia
    4. Pregnancy
    5. Drug or alcohol addiction
    6. Untreated or sever esophagitis
    • Potential acute complications
  • Band too tight with gastrointestinal obstructive symptoms (e.g. dysphagia)
  • Leakage of gastric content into abdomen
  • Hemorrhage
  • Deep vein thrombosis
  • Death
    • Potential chronic complications
  • Weight regain
  • Band slippage, erosion ulceration, port infection, disconnection and displacement
  • Esophageal dilation
  • Rare nutrient deficiencies if persistent vomiting or marked and sustained decrease in nutritional intake
  • Depression
  • Potential need to re-operate
  • GERD

    • Gastric bypass

    General
  • Hospital stay 2-4 days
  • Recovery 2-4 weeks
  • Contraindications
    1. Poor surgical candidates
    2. Sever psychiatric disorder
    3. Intolerance to general anesthesia
    4. Pregnancy
    5. Drug or alcohol addiction
    6. Untreated esophagitis
    7. Unwillingness or an inability for appropriate long-term follow-up
    • Potential acute complications
  • Gastrointestinal obstruction
  • Hemorrhage
  • Anastomotic leaks
  • Deep vein thrombosis
  • Pulmonary emboli
  • Dehydration
  • Death
    • Potential chronic complications
  • Weight regain
  • Marginal ulcer
  • Esophageal dilation
  • Dumping syndrome with reactive hypoglycemia
  • Small bowel obstruction caused by internal hernias or adhesions
  • Anastomotic stenoses (stomal narrowing)
  • Calcium defciency
  • Secondary hyperparathyroidism
  • Iron defciency
  • Protein malnutrition
  • Other nutritional and mineral defciencies (A,C,D,E,B and K, folate, zinc, magnesium, thiamine)
  • Anemia (often related to mineral and nutrition defciencies)
  • Metabolic acidosis
  • Bacterial overgrowth
  • Kidney stones (oxalosis)
  • Neuropathies (resulting from nutritional defciencies)
  • Osteoporosis (often caused by calcium defciencies and chronically elevated parathyroid hormone levels)
  • Depression
  • Potential need to reoperate