Bariatric surgery and complications

Bariatric surgery is an increasingly complex discipline based in four basic procedures: adjustable gastric banding, sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. Both in emergency and in daily practice, gastroenterologists are increasingly encountering bariatric patients and should be able to address the most frequently encountered problems. This chapter presents common endoscopic and radiographic findings, including normal views for orientation and basic anatomic illustration. While not exhaustive, this selection is made with an emphasis on the diagnosis of complications. Gastric bypass has been and remains an extremely effective weight loss procedure. Marginal ulceration is one common complication. Persistent ulceration can lead to stricture formation and stricture formation is readily treated endoscopically. A more urgent complication of gastric bypass, leak formation can also be treated endoscopically. Also presented is a super morbidly obese patient who had a biliopancreatic diversion with duodenal switch.