Complications after laparoscopic Roux-en-Y gastric bypass

The prevalence of obesity in the USA is increasing to epidemic proportions. Currently, more than 60% of Americans and 51% of Germans are overweight. The current standard for treatment of severe obesity, defined as a body mass index (BMI) of greater than 35 kg/m(2) with co-morbidities and generally greater than 40 kg/m(2), is surgical. These operations may be performed using laparoscopic surgical techniques to minimize perioperative morbidity and postoperative recovery time. In order to optimize the outcome of this type of procedure, bariatric surgery should be performed on carefully selected patients and in bariatric centers specially equipped to care for the obese, within a broadly based, multidisciplinary setting that provides lifelong postoperative care. It is a major surgery in high-risk patients with potential complications. The mortality of laparoscopic gastric bypass is up to 0.5%. Major complication rate ranges from 3 to 6.3%. Early complications after laparoscopic proximal Roux-en-Y gastric bypass (LRNYGB) include leak, bowel obstruction, deep vein thrombosis, and even death. The rate of leaks ranges from 0.8 to 5%, the rate of gastrointestinal hemorrhage is up to 1.1% and that of small bowel obstructions up to 1.8%. Minor complications include wound infections and incisional hernias. The rate of wound infections is higher with circular staplers than with linear stapling devices. Late complications after gastric bypass include anastomotic stricture and late bowel obstruction. Anastomotic stricture is a frequent late complication that occurs in 1.6-6.4% of the patients. The short-term and long-term complications after LRNYGB are described.