title: Complications of bariatric surgery: the acute care surgeon's experience.
abstract: BACKGROUND
  Complications of bariatric surgeries are common, can occur throughout the patient's lifetime, and can be life-threatening. We examined bariatric surgical complications presenting to our acute care surgery service.
  
  
  METHODS
  Records were reviewed from January 2007 to June 2013 for patients presenting with a complication after bariatric surgery.
  
  
  RESULTS
  Laparoscopic Roux-en-Y gastric bypass was the most common index operation (n = 20), followed by open Roux-en-Y gastric bypass (n = 6), laparoscopic gastric band (n = 4), and vertical banded gastroplasty (n = 3). Diagnoses included internal hernia (n = 10), small bowel obstruction (n = 5), lap band restriction (n = 4), biliary disease (n = 3), upper GI bleeding or ulcer (n = 3), ischemic bowel (n = 2), marginal ulcer (n = 2), gastric outlet obstruction (n = 2), perforated ulcer (n = 2), intussusception (n = 1), and incarcerated ventral hernia (n = 1). Operations were required in 91% of the patients. Laparoscopic outcomes were similar to open; however, open cases were more emergent (23.5% vs 69.2%) and had longer hospital length of stay (4.8 ± 3.5 vs 11.0 ± 10.3 days, P < .05). All patients survived.
  
  
  CONCLUSIONS
  The acute care surgeon will encounter complications of bariatric surgery. Internal hernias or obstructive etiologies are the most common presentations and often require emergent or urgent surgery.
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Joel F
authors.initials: JF
authors.lastname: Bradley
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Samuel W
authors.initials: SW
authors.lastname: Ross
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Ashley Britton
authors.initials: AB
authors.lastname: Christmas
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Peter E
authors.initials: PE
authors.lastname: Fischer
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sachdev
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA.
authors.forename: Brant Todd
authors.initials: BT
authors.lastname: Heniford
authors.affiliation: Department of General Surgery, Carolinas Medical Center, Charlotte, NC, USA. Electronic address: Ron.Sing@Carolinashealthcare.org.
authors.forename: Ronald F
authors.initials: RF
authors.lastname: Sing
mesh_terms: D000328:Adult; D050110:Bariatric Surgery / Q000009:adverse effects*; D005260:Female; D005767:Gastrointestinal Diseases / Q000209:etiology; D006547:Hernia / Q000209:etiology; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects; D007902:Length of Stay; D008297:Male; D010359:Patient Readmission / Q000706:statistics & numerical data; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies
keywords: Acute care surgery; Bariatric complications; Bariatric emergencies; Bariatric outcomes; Bariatric surgery