Common postbariatric surgery emergencies for the acute care surgeon: What you need to know

Vincent Cheng, Kamran Samakar, Adrian B. Dobrowolsky, James D. Nguyen, Stuart A. Abel, Andrea Pakula, Andrew Bernard, Matthew J. Martin

Research output: Contribution to journalReview articlepeer-review

Abstract

The field of bariatric and metabolic surgery has changed rapidly over the past two decades, with an exponential increase in case volumes being performed because of its proven efficacy for morbid obesity and obesity-related comorbidities. Although this increased volume of procedures has been accompanied by significant decrease in postoperative complication rates, there are numerous potential complications after bariatric surgery that may require urgent or emergent surgical evaluation or interventions. Many of these risks extend well beyond the early postoperative period and can present months to years after the index procedure. Acute care surgeons are increasingly covering most or all of the emergency general surgery services at many centers and must be familiar with the numerous bariatric surgical procedures being performed and their individual complication profile to provide optimal care for these frequently challenging patients. This article provides a focused and concise review of the common bariatric procedures being performed, their early and late complication profiles, and a practical guide to the optimal diagnostic evaluations, surgical interventions, and perioperative management options. The author group includes both acute care surgeons and bariatric surgeons with significant experience in the emergency management of the complicated postbariatric surgical patient. LEVEL OF EVIDENCE Literature Synthesis and Expert Opinion; Level V.

Original languageEnglish
Pages (from-to)817-831
Number of pages15
JournalJournal of Trauma and Acute Care Surgery
Volume95
Issue number6
DOIs
StatePublished - Dec 1 2023

Bibliographical note

Publisher Copyright:
© Wolters Kluwer Health, Inc. All rights reserved.

Keywords

  • acute care surgery
  • Bariatric surgery
  • complications
  • duodenal switch
  • gastric band
  • gastric bypass
  • sleeve gastrectomy

ASJC Scopus subject areas

  • Surgery
  • Critical Care and Intensive Care Medicine

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