Gastric bypass is much safer now than when it was first performed regularly in 1988. At that time, bariatric surgeons generally performed it as an open procedure with a large incision to reach the stomach and small intestine. Today, surgeons almost always operate laparoscopically unless they encounter a problem. Laparoscopy in weight loss surgery dramatically reduces the chance of infection and other common side effects.
All surgeries carry some risk. Bariatric surgeries, while generally considered safe, bring their type of risks, some of which can lead to short-term side effects as well as long-term complications. Learning about the risks associated with bariatric surgery and closely following your doctor's recommendations can reduce your risk of adverse side effects.
Can You Die from Gastric Bypass Surgery?
Dying as a result of having gastric bypass surgery is extremely rare. The gastric bypass surgery death rate is minuscule as the procedure has a 99.8% survival rate. In fact, the chances of dying early from an obesity-related health issue are much greater. Gastric bypass is about as risky as gallbladder surgery and has much less risk than a hip replacement or a C-section.
In an analysis done by the University of Iowa, only 93 out of 38,501 bariatric patients died within 30 days of surgery. The most common causes were:
- Pulmonary embolism
- Leaks from the surgical connections or staple lines causing infection
- Small bowel obstruction
How Safe is Gastric Bypass Surgery for Patients With Extreme Obesity?
Medical research indicates that gastric bypass surgery complications increase with a higher body mass index (BMI). Patients with a BMI greater than 70 have a slightly higher risk for mortality and stay in the hospital longer than those with a lower BMI.
Those with higher BMI have a greater risk for developing deep vein thrombosis, infections, and kidney issues. The risk is the same, no matter the BMI, for heart attacks and pulmonary embolism. However, the general risk for all of these conditions remains low.
Gastric Bypass Surgery Success Rate
If you wonder how effective gastric bypass surgery is, the statistics associated with it speak for themselves.
After one year, patients lose an average of 65% of their excess weight.
Five-year weight loss averages 60%, including at least one weight loss plateau. Patients also have significant improvements in health problems related to obesity, including type 2 diabetes, hypertension, and sleep apnea. Weight loss and resolution of health issues are generally better than more minimally invasive weight loss procedures like gastric sleeve surgery.
Gastric Bypass Side Effects
As with any bariatric surgery, side effects are possible. While about 40% of patients experience side effects or complications after gastric bypass surgery, so discuss the potential risks with your surgeon before undergoing surgery.
Some of the more common immediate side effects include:
- Constipation
- Infection at the wound site
- Anesthesia problems
- Acid reflux
- Dilation of the esophagus
- Chronic nausea and vomiting
- Stomach obstruction
- Inability to eat certain foods
Gastric Bypass: Complications
Complications usually manifest several days to several weeks after the procedure. Some problems may require follow-up surgery to remedy the complication. Common complications are:
- Internal bleeding
- Damage to the spleen or other internal organs
- Perforation of the stomach or intestines
- Leaks coming from the anastomosis or newly made connections in the digestive tract
- Obstructions in the pouch, anastomoses, or small intestine
- Cardiac or pulmonary problems
Anastomotic Leak Symptoms and Diagnosis
Anastomotic leaks are among the most serious complications occurring because of the changes made to the digestive system. They can occur in up to 6% of bypass procedures, with morbidly obese and male patients more at risk, along with those having a history of abdominal surgery. Symptoms include:
- Rapid heart rate
- Fever
- Stomach pain
- Drainage from a surgical wound
- Nausea and vomiting
- Pain in the left shoulder area
- Low blood pressure
- Decreased urine output
To diagnose an anastomotic leak, you must have an upper GI or a CT scan. Even if your test is negative and you still experience symptoms, your doctor may recommend emergency surgery. Typical treatments are:
- Intravenous antibiotics
- Drain the infection, repair the leak or create a new anastomosis
- Place a temporary stent across the leaking area
- No oral feeding until the leak has completely healed
A leaking anastomosis may cause severe bleeding and infection and can be life-threatening. Long-term complications may include ulcers, scarring, and narrowing where the intestine is connected to the gastric pouch. Drainage tracts called fistulas may develop. Pneumonia can occur if digestive juices flow into the lungs.
Long-term side effects of gastric bypass surgery can vary and include:
- Bowel obstruction
- Gallstones
- Hernias
- Low blood sugar
- Malnutrition
- Ulcers
- Acid reflux
- The need for revision surgery
Dumping syndrome is one of the most common severe negative effects of gastric bypass surgery. This complication results in nausea, vomiting, dizziness, flushing, and rapid heart rate when patients consume too many carbohydrates within a short amount of time. Symptoms can range from mild to severe.
Gastric Bypass Surgery: Pros and Cons
Simply undergoing this procedure can help patients achieve a healthier weight, eliminate sleep apnea, reverse type 2 diabetes, and improve high blood pressure, leading to a longer, healthier life. These factors alone often outweigh the risks.
What are the Negative Long-Term Effects of Gastric Bypass Surgery?
Most negative long-term problems result from the rerouting of the small intestine. Blockages or twists can occur, necessitating revision surgery. The most troublesome negative effects are the development of hypoglycemia and an increased risk of stomach ulcers.
The latter can cause severe pain, anemia, or bleeding and primarily occur because of NSAID pain killers. Hypoglycemia, or low blood sugar, occurs without warning and appears to be related to hormonal changes caused by the surgery.
Nutritional deficiencies also arise over time, necessitating the supplementation of a daily multivitamin. The most common deficiencies involve iron, Vitamin B12 and Vitamin D. Not treating these nutritional deficiencies can lead to fatigue, neuropathy, and bone density loss over time.
Weight Regain is the Most Dangerous Long-Term Complication
No matter what type of bariatric surgery you have, the most dangerous long-term effect involves weight regain.
Obesity is a far worse problem than all of the previously mentioned adverse effects. The inability to lose weight sufficiently and keep it off stems from the underlying disease of obesity which has complex causes.
Gastric bypass surgery is a relatively safe procedure and in most case where it is needed, much safer than leaving surgery undone.
