Basic Postoperative Management of the Bariatric Patient

  • Mitchell S. Roslin
  • Diana McPhee
  • Sujit Kulkarni
Chapter

Abstract

Maintenance of adequate caloric intake, progression of key milestones, and knowing what complications to consider for each specific procedure are critical in the postoperative management of bariatric patients. It is essential that all practitioners involved in the care of bariatric patients understand the various procedures and are familiar with postoperative issues. All patients need to be monitored closely in the postoperative period to minimize side effects while continuing to offer good weight loss results. The purpose of this chapter will be to highlight key issues in postoperative management of the various procedures and touch briefly on what complications should be considered during this period.

Keywords

Obesity Catheter Carbohydrate Titration Polypeptide 

References

  1. 1.
    Faintuch J, Matsuda M, Cruz ME, et al. Severe protein-calorie malnutrition after bariatric procedures. Obes Surg. 2004;14(2):175–81.PubMedCrossRefGoogle Scholar
  2. 2.
    Sugerman HJ. Bariatric surgery for severe obesity. J Assoc Acad Minor Phys. 2001;12:129–36.PubMedGoogle Scholar
  3. 3.
    Michalik M, Lech P, Bobowicz M, Orlowski M, Lehmann A. A 5-year experience with laparoscopic adjustable gastric banding—focus on outcomes, complications, and their management. Obes Surg. 2011;21(11):1682–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Wang Y, Liu J. Plasma ghrelin modulation in gastric band operation and sleeve gastrectomy. Obes Surg. 2009;19(3):357–62.PubMedCrossRefGoogle Scholar
  5. 5.
    Keidar A, Szold A, Carmon E, Blanc A, Abu-Abeid S. Band slippage after laparoscopic adjustable gastric banding: etiology and treatment. Surg Endosc. 2005; 19:262–7.PubMedCrossRefGoogle Scholar
  6. 6.
    Mognol P, Chosidow D, Marmuse JP. Laparoscopic sleeve gastrectomy (LSG): review of a new bariatric procedure and initial results. Surg Technol Int. 2006;15:47–52. Review.PubMedGoogle Scholar
  7. 7.
    Peterli R, Steinert RE, Woelnerhanssen B, Peters T, Christoffel-Courtin C, Gass M, et al. Metabolic and hormonal changes after laparoscopic Roux-en-Y gastric bypass and sleeve gastrectomy: a randomized, prospective trial. Obes Surg. 2012;22(5):740–8.PubMedCrossRefGoogle Scholar
  8. 8.
    Fernandez Jr AZ, DeMaria EJ, Tichansky DS, et al. Experience with over 3000 open and laparoscopic bariatric procedures: multivariate analysis of factors related to leak and resultant mortality. Surg Endosc. 2004;18:193–7.PubMedCrossRefGoogle Scholar
  9. 9.
    Puli SR, Spofford IS, Thompson CC. Use of self-expandable stents in the treatment of bariatric surgery leaks: a systematic review and meta-analysis. Gastrointest Endosc. 2012;75(2):287–93.PubMedCrossRefGoogle Scholar
  10. 10.
    Petersen WV, Meile T, Küper MA, Zdichavsky M, Königsrainer A, Schneider JH. Functional importance of laparoscopic sleeve gastrectomy for the lower esophageal sphincter in patients with morbid obesity. Obes Surg. 2012;22(3):360–6.PubMedCrossRefGoogle Scholar
  11. 11.
    Brolin RE, Gorman JH, Gorman RC, et al. Are vitamin B12 and folate deficiency clinically important after roux-en-Y gastric bypass? J Gastrointest Surg. 1998;2:436–42.PubMedCrossRefGoogle Scholar
  12. 12.
    Skrekas G, Antiochos K, Stafyla VK. Laparoscopic gastric greater curvature plication: results and ­complications in a series of 135 patients. Obes Surg. 2011;21(11):1657–63.PubMedCrossRefGoogle Scholar
  13. 13.
    Brolin RE. Laparoscopic verses open gastric bypass to treat morbid obesity. Ann Surg. 2004;239(4): 438–40.PubMedCrossRefGoogle Scholar
  14. 14.
    Hatizifotis M, Dolan K, Newbury L, et al. Symptomatic vitamin A deficiency following biliopancreatic diversion. Obes Surg. 2003;13(4):655–7.PubMedCrossRefGoogle Scholar
  15. 15.
    Livingston EH. Procedure, incidence and complication rates of bariatric surgery in the United States. Am J Surg. 2004;188:105–10.PubMedCrossRefGoogle Scholar
  16. 16.
    Capella JF, Capella RF. Gastro-gastric fistulas and marginal ulcers in gastric bypass procedures for weight reduction. Obes Surg. 1999;9:22–7.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Mitchell S. Roslin
    • 1
  • Diana McPhee
    • 1
  • Sujit Kulkarni
    • 1
  1. 1.Department of General and Minimally Invasive SurgeryLenox Hill HospitalNew YorkUSA

Personalised recommendations