Gastric bypass, which combines restrictive and malabsorptive surgery techniques, is the most frequently performed bariatric procedure in the United States. In this procedure , Stapling creates a small (15 to 20 cc) stomach pouch. The reminder of the stomach is not removed, but is completely stapled shut and divided from the lower stomach pouch. The outlet from this newly formed pouch empties directly in to the lower portion of the jejunum, thus bypassing calorie absorption and the duodenum. To achieve this, the small intestine is divided just beyond the duodenum and a connection with the new, smaller stomach pouch is constructed. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.
- Limits the amount of food that can be eaten at a meal and reduces the desire to eat
- Average excess weight loss generally higher than with gastric banding or sleeve gastrectomy
- No postoperative adjustments are required
- An analysis of clinical studies reported an average excess weight loss of 61.6% in 4204 patients
- Shown to help resolve type2 diabetes, high blood pressure, and obstructive sleep apnea, and to help improve high cholesterol
- In a study of 608 gastric bypass patients, 553 maintained contact for 14 years; the study reported that significant weight loss was maintained in 14 years10
The following are in addition to the general risks of surgery :
Because the duodenum is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. Women should be aware f the potential for heightened bone calcium loss
- Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back, and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements
- Chronic anemia due to vitamin B12 deficiency can occur. This can usually be managed with vitamin B12 pills or injection
- When removing or bypassing the pylorus, a condition known as duming syndrome can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amount of food are consumed. While generally not considered to be a serious risk to your health, the result can be extremely unpleasant and can include nausea, weakness, sweating, faintness, and, on occasion, diarrhea after eating
- In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15 to 30 cc
- Rerouting of bile, pancreatic and other digestive juices beyond the stomach can cause intestinal irritation and ulcers
- Pouch dilatation
- The lower stomach pouch and segments of the small intestine cannot be easily visualized using x-ray or endoscopy if problem such as ulcers, bleeding, or malignancy should occur talk with your surgeon about the possible surgical risks.