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Bariatric Emergencies for the General Surgeon

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The SAGES Manual of Bariatric Surgery

Abstract

Between 2011 and 2015, nearly one million bariatric surgeries were performed in the United States. With around 200,000 weight loss operations being performed annually in the United States, general surgeons face a growing number of bariatric surgical emergencies. This chapter deals with the most common surgical emergencies following the three most common bariatric surgeries being done currently and the best way in which to deal with them. The principles of rescue therapy and damage control are as applicable to the bariatric surgery patient as they are to trauma and general surgery patients. There are specific maneuvers for some of these emergencies, but in general, good surgical technique and judgment of the surgeon will prevail. In this chapter, we will discuss the algorithm of evaluating the emergent patient and approaches to diagnosis and treatment. Emergencies may be surgical in nature but may also be related to nutritional deficiencies. We will discuss how to assess for these nutritional deficiencies and best treatment options.

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Author information

Authors and Affiliations

  1. Department of Surgery, University of Texas Health San Antonio, San Antonio, TX, USA

    Richard M. Peterson, Pedro Pablo Gomez & Patrick Nguyen

Authors
  1. Richard M. Peterson
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  2. Pedro Pablo Gomez
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  3. Patrick Nguyen
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Corresponding author

Correspondence to Richard M. Peterson .

Editor information

Editors and Affiliations

  1. Foregut and Bariatric Surgeon, Division of Gastrointestinal and Minimally Invasive Surgery, The Oregon Clinic, Portland, Oregon, USA

    Kevin M. Reavis

  2. Long Island Jewish Forest Hills Hospital, Department of Surgery, Hofstra-Northwell School of Medicine, Forest Hills, New York, USA

    Allison M. Barrett

  3. Institute Chief, Digestive Disease Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates

    Matthew D. Kroh

Appendix

Appendix

Fig. 41.18
figure 18

General algorithm for bariatric surgery emergencies

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Fig. 41.19
figure 19

Bypass algorithm A (<30 days from surgery) for bariatric surgery emergencies. Abbreviations: ED emergency department, CT computed tomography, PO per oral

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Fig. 41.20
figure 20

Bypass algorithm B (>30 days from surgery) for bariatric surgery emergencies. Abbreviations: ED emergency department, CT computed tomography, PPI proton pump inhibitor, GI gastrointestinal, BID two times daily, NPO nil per os, JJ jejunojejunostomy, IV intravenous, PO per oral

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Fig. 41.21
figure 21

Sleeve gastrectomy algorithm for bariatric surgery emergencies. Abbreviations: GI gastrointestinal, CT computed tomography, IV intravenous, PO per oral

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Fig. 41.22
figure 22

Adjustable gastric band algorithm for bariatric surgery emergencies. Abbreviations: UGI upper gastrointestinal

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Peterson, R.M., Gomez, P.P., Nguyen, P. (2018). Bariatric Emergencies for the General Surgeon. In: Reavis, K., Barrett, A., Kroh, M. (eds) The SAGES Manual of Bariatric Surgery. Springer, Cham. https://doi.org/10.1007/978-3-319-71282-6_41

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  • DOI: https://doi.org/10.1007/978-3-319-71282-6_41

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