title: Managing medical and surgical disorders after divided Roux-en-Y gastric bypass surgery.
abstract: The National Longitudinal Study of Adolescent Health and the National Health and Nutrition Examination Survey reported that over 40% of the US population is overweight. The average weight loss attained by medical management programs is neither sufficient nor durable enough to treat medically complicated obesity. An estimated 220,000 bariatric procedures are performed yearly in the USA and Canada. The divided Roux-en-Y gastric bypass (RYGB) is performed most commonly in these countries and is considered the gold standard bariatric surgical procedure. The complexity of RYGB means that serious and potentially preventable perioperative complications can occur. RYGB alters the normal anatomy and physiology of the upper gut, which has predictable adverse effects and potential complications. Patients seek advice and care for symptoms that develop or persist after RYGB; although some symptoms are expected and predictable, others are complications that may or may not require active medical or surgical intervention. Physicians should be able to predict and manage most postoperative medical and nutritional disorders related to RYGB and should be prepared to assess patients for potential referral for surgical intervention or revision.
authors.affiliation: Section of Gastroenterology, Washington Hospital Center and Georgetown University School of Medicine, Washington, DC 20010, USA.
authors.forename: Bikram
authors.initials: B
authors.lastname: Bal
authors.forename: Timothy R
authors.initials: TR
authors.lastname: Koch
authors.forename: Frederick C
authors.initials: FC
authors.lastname: Finelli
authors.forename: Michael G
authors.initials: MG
authors.lastname: Sarr
mesh_terms: D015390:Gastric Bypass / Q000009:adverse effects* / Q000379:methods; D006801:Humans; D007581:Jejunoileal Bypass; D044342:Malnutrition / Q000503:physiopathology; D009748:Nutrition Disorders / Q000628:therapy; D009767:Obesity, Morbid / Q000601:surgery; D010538:Peritonitis; D011182:Postoperative Care; D011183:Postoperative Complications / Q000628:therapy; D015430:Weight Gain; D015431:Weight Loss
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