Skip to main content
SpringerLink
Log in

Preoperative Evaluation and Contraindications to Bariatric Surgery

  • Chapter
  • First Online:
Bariatric Surgical Practice Guide

  • 941 Accesses

Abstract

Bariatric surgery is the most effective treatment option for the morbidly obese patients who fail weight loss by lifestyle interventions [1]. In addition to weight loss, it results in resolution or improvement of obesity associated co-morbidities of diabetes, hypertension, dyslipidemia, obstructive sleep apnea, gastro-esophageal reflux etc. Improvement in long-term survival and overall quality of life has been demonstrated in several studies. It has been shown that morbidly obese patients are high risk candidates for any surgical intervention [2, 3]. They can have several potential perioperative and long term complications after surgical intervention. Hence any patient who needs to be subjected to bariatric surgery should be thoroughly evaluated and accordingly optimized prior to surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 129.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. NIH conference. Gastrointestinal surgery for severe obesity. Consensus Development Conference Panel. Ann Intern Med. 1991;115(12):956–61.

    Google Scholar 

  2. Parkin L, Sweetland S, Balkwill A, Green J, Reeves G, Beral V, et al. Body mass index, surgery, and risk of venous thromboembolism in middle-aged women: a cohort study. Circulation. 2012;125(15):1897–904.

    Article  PubMed  Google Scholar 

  3. Yeh P-S, Lee Y-C, Lee W-J, Chen S-B, Ho S-J, Peng W-B, et al. Clinical predictors of obstructive sleep apnea in Asian bariatric patients. Obes Surg. 2010;20(1):30–5.

    Article  PubMed  Google Scholar 

  4. Whitaker RC, Wright JA, Pepe MS, Seidel KD, Dietz WH. Predicting obesity in young adulthood from childhood and parental obesity. N Engl J Med. 1997;337(13):869–73.

    Article  CAS  PubMed  Google Scholar 

  5. Snyder AG. Psychological assessment of the patient undergoing bariatric surgery. Ochsner J. 2009;9(3):144–8.

    PubMed  PubMed Central  Google Scholar 

  6. Greenberg I, Sogg S, M Perna F. Behavioral and psychological care in weight loss surgery: best practice update. Obes Silver Spring Md. 2009;17(5):880–4.

    Article  Google Scholar 

  7. Goldstein N, Hadidi N. Impact of bariatric pre-operative education on patient knowledge and satisfaction with overall hospital experience. Bariatr Nurs Surg Patient Care. 2010;5(2):137–44.

    Article  Google Scholar 

  8. Walfish S, Vance D, Fabricatore AN. Psychological evaluation of bariatric surgery applicants: procedures and reasons for delay or denial of surgery. Obes Surg. 2007;17(12):1578–83.

    Article  PubMed  Google Scholar 

  9. Zalesin KC, Franklin BA, Miller WM, Peterson ED, McCullough PA. Impact of obesity on cardiovascular disease. Med Clin North Am. 2011;95(5):919–37.

    Article  PubMed  Google Scholar 

  10. Fleisher LA, Beckman JA, Brown KA, Calkins H, Chaikof E, Fleischmann KE, et al. ACC/AHA 2007 guidelines on perioperative cardiovascular evaluation and care for noncardiac surgery: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines on Perioperative Cardiovascular Evaluation for Noncardiac Surgery): developed in collaboration with the American Society of Echocardiography, American Society of Nuclear Cardiology, Heart Rhythm Society, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society for Vascular Medicine and Biology, and Society for Vascular Surgery. Circulation. 2007;116(17):e418–99.

    Article  PubMed  Google Scholar 

  11. Mertens I, Van Gaal LF. Obesity, haemostasis and the fibrinolytic system. Obes Rev Off J Int Assoc Study Obes. 2002;3(2):85–101.

    Article  CAS  Google Scholar 

  12. Kuruba R, Koche LS, Murr MM. Preoperative assessment and perioperative care of patients undergoing bariatric surgery. Med Clin North Am. 2007;91(3):339–51, ix.

    Article  PubMed  Google Scholar 

  13. Zierler BK. Ultrasonography and diagnosis of venous thromboembolism. Circulation. 2004;109(12 Suppl 1):I9–14.

    Article  PubMed  Google Scholar 

  14. Mosen DM, Schatz M, Magid DJ, Camargo CA. The relationship between obesity and asthma severity and control in adults. J Allergy Clin Immunol. 2008;122(3):507–11.e6.

    Article  PubMed  Google Scholar 

  15. Beuther DA, Sutherland ER. Overweight, obesity, and incident asthma: a meta-analysis of prospective epidemiologic studies. Am J Respir Crit Care Med. 2007;175(7):661–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Masoomi H, Reavis KM, Smith BR, Kim H, Stamos MJ, Nguyen NT. Risk factors for acute respiratory failure in bariatric surgery: data from the Nationwide Inpatient Sample, 2006-2008. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2013;9(2):277–81.

    Article  Google Scholar 

  17. Mechanick JI, Youdim A, Jones DB, Timothy Garvey W, Hurley DL, Molly McMahon M, et al. Clinical practice guidelines for the perioperative nutritional, metabolic, and nonsurgical support of the bariatric surgery patient – 2013 update: cosponsored by American Association of Clinical Endocrinologists, the Obesity Society, and American Society for Metabolic & Bariatric Surgery. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2013;9(2):159–91.

    Article  Google Scholar 

  18. Janković D, Wolf P, Anderwald C-H, Winhofer Y, Promintzer-Schifferl M, Hofer A, et al. Prevalence of endocrine disorders in morbidly obese patients and the effects of bariatric surgery on endocrine and metabolic parameters. Obes Surg. 2012;22(1):62–9.

    Article  PubMed  Google Scholar 

  19. Perna M, Romagnuolo J, Morgan K, Byrne TK, Baker M. Preoperative hemoglobin A1c and postoperative glucose control in outcomes after gastric bypass for obesity. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2012;8(6):685–90.

    Article  Google Scholar 

  20. Lee W-J, Ser K-H, Chong K, Lee Y-C, Chen S-C, Tsou J-J, et al. Laparoscopic sleeve gastrectomy for diabetes treatment in nonmorbidly obese patients: efficacy and change of insulin secretion. Surgery. 2010;147(5):664–9.

    Article  PubMed  Google Scholar 

  21. Lee W-J, Chong K, Ser K-H, Chen J-C, Lee Y-C, Chen S-C, et al. C-peptide predicts the remission of type 2 diabetes after bariatric surgery. Obes Surg. 2012;22(2):293–8.

    Article  PubMed  Google Scholar 

  22. Hampel H, Abraham NS, El-Serag HB. Meta-analysis: obesity and the risk for gastroesophageal reflux disease and its complications. Ann Intern Med. 2005;143(3):199–211.

    Article  PubMed  Google Scholar 

  23. Greenwald D. Preoperative gastrointestinal assessment before bariatric surgery. Gastroenterol Clin North Am. 2010;39(1):81–6.

    Article  PubMed  Google Scholar 

  24. Praveenraj P, Gomes RM, Kumar S, Senthilnathan P, Parathasarathi R, Rajapandian S, et al. Diagnostic yield and clinical implications of preoperative upper gastrointestinal endoscopy in morbidly obese patients undergoing bariatric surgery. J Laparoendosc Adv Surg Tech A. 2015;25(6):465–9.

    Article  PubMed  Google Scholar 

  25. Dixon JB, Bhathal PS, O’Brien PE. Nonalcoholic fatty liver disease: predictors of nonalcoholic steatohepatitis and liver fibrosis in the severely obese. Gastroenterology. 2001;121(1):91–100.

    Article  CAS  PubMed  Google Scholar 

  26. Beymer C, Kowdley KV, Larson A, Edmonson P, Dellinger EP, Flum DR. Prevalence and predictors of asymptomatic liver disease in patients undergoing gastric bypass surgery. Arch Surg Chic Ill 1960. 2003;138(11):1240–4.

    Google Scholar 

  27. Gholam PM, Kotler DP, Flancbaum LJ. Liver pathology in morbidly obese patients undergoing Roux-en-Y gastric bypass surgery. Obes Surg. 2002;12(1):49–51.

    Article  PubMed  Google Scholar 

  28. Ong JP, Elariny H, Collantes R, Younoszai A, Chandhoke V, Reines HD, et al. Predictors of nonalcoholic steatohepatitis and advanced fibrosis in morbidly obese patients. Obes Surg. 2005;15(3):310–5.

    Article  PubMed  Google Scholar 

  29. Praveenraj P, Gomes RM, Kumar S, Karthikeyan P, Shankar A, Parthasarathi R, et al. Prevalence and predictors of non-alcoholic fatty liver disease in morbidly obese South Indian patients undergoing bariatric surgery. Obes Surg. 2015;25(11):2078–87.

    Article  PubMed  Google Scholar 

  30. Praveen Raj P, Gomes RM, Kumar S, Senthilnathan P, Karthikeyan P, Shankar A, et al. The effect of surgically induced weight loss on nonalcoholic fatty liver disease in morbidly obese Indians: “NASHOST” prospective observational trial. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2015;11(6):1315–22.

    Article  CAS  Google Scholar 

  31. Fobi M, Lee H, Igwe D, Felahy B, James E, Stanczyk M, et al. Prophylactic cholecystectomy with gastric bypass operation: incidence of gallbladder disease. Obes Surg. 2002;12(3):350–3.

    Article  PubMed  Google Scholar 

  32. Dittrick GW, Thompson JS, Campos D, Bremers D, Sudan D. Gallbladder pathology in morbid obesity. Obes Surg. 2005;15(2):238–42.

    Article  PubMed  Google Scholar 

  33. Fris RJ. Preoperative low energy diet diminishes liver size. Obes Surg. 2004;14(9):1165–70.

    Article  PubMed  Google Scholar 

  34. Selke H, Norris S, Osterholzer D, Fife KH, DeRose B, Gupta SK. Bariatric surgery outcomes in HIV-infected subjects: a case series. AIDS Patient Care STDS. 2010;24(9):545–50.

    Article  PubMed  Google Scholar 

  35. Kanadys WM, Leszczyńska-Gorzelak B, Oleszczuk J. Obesity among women. Pregnancy after bariatric surgery: a qualitative review. Ginekol Pol. 2010;81(3):215–23.

    PubMed  Google Scholar 

  36. Tan O, Carr BR. The impact of bariatric surgery on obesity-related infertility and in vitro fertilization outcomes. Semin Reprod Med. 2012;30(6):517–28.

    Article  PubMed  Google Scholar 

  37. Olbers T, Gronowitz E, Werling M, Mårlid S, Flodmark C-E, Peltonen M, et al. Two-year outcome of laparoscopic Roux-en-Y gastric bypass in adolescents with severe obesity: results from a Swedish Nationwide Study (AMOS). Int J Obes (Lond) 2005. 2012;36(11):1388–95.

    Article  CAS  Google Scholar 

  38. Flum DR, Salem L, Elrod JAB, Dellinger EP, Cheadle A, Chan L. Early mortality among Medicare beneficiaries undergoing bariatric surgical procedures. JAMA. 2005;294(15):1903–8.

    Article  CAS  PubMed  Google Scholar 

  39. Livingston EH, Langert J. The impact of age and Medicare status on bariatric surgical outcomes. Arch Surg Chic Ill 1960. 2006;141(11):1115–20; discussion 1121.

    Google Scholar 

  40. Willkomm CM, Fisher TL, Barnes GS, Kennedy CI, Kuhn JA. Surgical weight loss >65 years old: is it worth the risk? Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2010;6(5):491–6.

    Article  Google Scholar 

  41. Lynch J, Belgaumkar A. Bariatric surgery is effective and safe in patients over 55: a systematic review and meta-analysis. Obes Surg. 2012;22(9):1507–16.

    Article  PubMed  Google Scholar 

  42. Ramirez A, Roy M, Hidalgo JE, Szomstein S, Rosenthal RJ. Outcomes of bariatric surgery in patients >70 years old. Surg Obes Relat Dis Off J Am Soc Bariatr Surg. 2012;8(4):458–62.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Bariatric Division, Upper Gastrointestinal Surgery and Minimal Access Surgery Unit, GEM Hospital and Research Centre, Coimbatore, India

    Saravana Kumar MS, FMAS & Rachel Maria Gomes MS, FMAS

Authors
  1. Saravana Kumar MS, FMAS
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Rachel Maria Gomes MS, FMAS
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Saravana Kumar MS, FMAS .

Editor information

Editors and Affiliations

  1. Bariatric Division, Upper Gastrointestinal Surgery and Minimal Access Surgery Unit, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India

    Saravana Kumar

  2. Bariatric Division, Upper Gastrointestinal Surgery and Minimal Access Surgery Unit, GEM Hospital and Research Centre, Coimbatore, Tamil Nadu, India

    Rachel Maria Gomes

Rights and permissions

Reprints and permissions

Copyright information

© 2017 Springer Nature Singapore Pte Ltd.

About this chapter

Cite this chapter

Kumar, S., Gomes, R.M. (2017). Preoperative Evaluation and Contraindications to Bariatric Surgery. In: Kumar, S., Gomes, R. (eds) Bariatric Surgical Practice Guide. Springer, Singapore. https://doi.org/10.1007/978-981-10-2705-5_4

Download citation

  • DOI: https://doi.org/10.1007/978-981-10-2705-5_4

  • Published:

  • Publisher Name: Springer, Singapore

  • Print ISBN: 978-981-10-2704-8

  • Online ISBN: 978-981-10-2705-5

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation