Most patients will not experience any complications of their surgery. Nonetheless, complications from surgery and anesthesia may occur.

Roux-en-Y gastric bypass and duodenal switch are associated with a complication rate of about 20 percent (one in five). This means that about one in five patients will have some type of complication after surgery.

Most complications are minor, such as drainage from a skin incision, a urinary tract infection, nausea, or abdominal wall muscle spasms with pain. Occasionally, however, complications can be major (less than 1 percent), such as a serious wound infection, intra-abdominal bleeding, infections within the abdomen, and hernias.

Very rarely, life-threatening complications can occur including heart attacks, strokes, leakage from a suture line, and blood clots in the deep veins of the legs which can break off and travel up to the lungs (pulmonary embolism). Although even these serious complications can usually be treated successfully, they can result in permanent disability and even death.

Many patients develop some loose, flabby skin on their arms, breasts, ankles, and legs after weight loss with less obvious changes on the face and neck. In some cases, patients want to have plastic surgery to fix this problem. You should contact your insurance carrier to see if they cover such procedures -- many consider them to be cosmetic surgery and do not cover the expense.

We can refer you to the Duke Center for Aesthetic Services if you wish a consultation.

Plastic surgery is not considered until at least one year after your surgery and only when you reach a stable weight. The more you exercise, the less likely you will need plastic surgery.

Emotional Changes

Be prepared for emotional ups and downs after you go home from the hospital. Some patients feel like they are on an emotional roller coaster. These feelings are completely normal and usually go away after several weeks. If these feelings continue or get worse, we will arrange for you to get help from our psychologist.

Dumping Syndrome

Occasionally, following the Roux-en-Y gastric bypass procedure, patients will have problems with food emptying from the stomach too quickly. A syndrome can develop that is characterized by bloating, cramps, nausea, vomiting, sweating, rapid heartbeat, occasional fainting, and diarrhea. The problem usually is mild and resolves over several weeks.

When severe a special diet is needed to slow gastric emptying:

• Avoid foods that are high in osmolarity (high fat, fried, greasy foods and sweets or surgary foods)
• Protein and fat may be increased in this diet. High protein foods include milk, eggs, meat, fish, cheese, peanut butter, and dried beans. Fat is used in amounts that are tolerated
• Meals are divided into six small servings

Liquids should not be given with meals. Liquids should be given 30 - 60 minutes before or after meals. Liquids are fluids or foods that are fluid at room temperature -- such as Jell-O, ice cream, or sherbet. Do not drink very hot or very cold liquids and avoid caffeine.

Loose Stools

Duodenal switch patients may experience frequent foul-smelling loose stools. This is due to significant malabsorption from this procedure. Avoiding fatty foods may help improve this problem.

Band Slippage

This unique problem from gastric banding occurs if the band position on your stomach shifts. It may result in obstruction or weight gain. Rarely, it causes pinching in your stomach.

Other Complications

There are other possible complications following surgery. These will be detailed at your preoperative surgical visit.

Patient Manual Index

• Introduction
• Questions to Ask Your Insurance Company
• Your Health Care Team
• Roux-en-Y Gastric Bypass
• Adjustable Gastric Banding Procedure
• Sleeve Gastrectomy
• Duodenal Switch
• Revisional Procedures
• Path to Surgery
• The First Clinic Visit
• The Preoperative Surgical Clinic Visit
• The Preoperative Educational Clinic Visit
• Preparation Instructions for Surgery
• Day of Surgery and Postoperative Stay
• Hospital Course Following a Roux-en-Y Gastric Bypass
• Hospital Course Following an Adjustable Gastric Banding Procedure
• Post Surgery Follow-up Care
• Potential Complications of Surgery