Gastric Bypass Complications
Gastric bypass surgery complications can be categorized as early (occurring within 30 days of surgery), or late (occurring after 30 days).
Early gastric bypass surgery complications include leaks, blood clots, bleeding, infection, dehydration, stricture, etc. Late complications include vitamin/mineral deficiencies, internal hernias, ulcers, alcohol abuse, hypoglycemia, weight regain, etc.
Below is a discussion about leak (the most important early complication), and 30-day complication rate (measure of all early complications).
Gastric Bypass Leak
A leak is a serious and feared complication that can occur after gastric bypass surgery. A leak is a hole that occurs in the stomach or intestine early after surgery before complete healing has occurred. A gastric bypass leak can result in a serious infection, the need for subsequent procedures/operations, and a prolonged hospital stay.
The good news about gastric sleeve leaks is that they are largely preventable with good surgical technique.* The bad news is that preventing leaks is easier said than done, and not all surgeons are equally successful at preventing leaks.*
The average leak rate for gastric bypass surgery is somewhere in the 1-2% range (see table below).* This, however, is not the leak rate for all gastric bypass surgeons. Some surgeons achieve lower leak rates than the average, and some achieve higher leak rates than the average.*
Gastric Bypass Leak – Our Results
Dr. Oliak’s leak rate for laparoscopic gastric bypass (first time and revision operations) is <0.1% (1 in 1,095 operations).*
Dr. Oliak’s <0.1% gastric bypass leak rate is lower than the industry average gastric bypass leak rate of 1-2% (see discussion below).*
Gastric Bypass Leak – Published Studies
There have been many studies published on gastric bypass leak rates, by many surgeons, over the past 20+ years. Recent large studies on gastric bypass leak report the overall average gastric bypass leak rate to be 1-2% (see table below).*
This, however, is not the leak rate for all surgeons. Some surgeons achieve lower leak rates than the average, and some achieve higher leak rates than the average. Published studies report individual surgeon report leak rates to be as low as 0%, and as high as 8%.*
Gastric Bypass Leak – Published Studies*
|Author||Date Published||Study Type||Total Patients||Overall Leak Rate*|
|Zellmer et al||2014||review – 28 studies||10,900||1.9%|
|Chang et al||2018||review – 71 studies||107,874||1.14%|
|Kumar et al||2018||2015 COE Data||41,080||1.6%|
* Leaks can occur after gastric bypass surgery. Past performance does not guarantee future results.
Gastric Bypass 30-day Complication Rate
30-day complication rate is a common outcomes measure for many different types of surgeries. The statistic is relatively easy to get from hospital billing data so large numbers of patients can be evaluated, and the statistic is useful medically because most surgery related complications occur within the first month after surgery.
One recent large study, described below, evaluated 30-day gastric bypass (and gastric sleeve) complication rates.
Kumar et al, in a 2018 study, evaluated 41,080 gastric bypass patients that had surgery in 2015, and reported the overall 30-day gastric bypass complication rate to be 11.7%.* Kumar did not report on the variation in complication rates between different surgeons/programs.
Our 30-day complication rate for gastric bypass operations performed 2010-2017 is 5.7%, half the rate as in the review study above.*
Another recent large study, described below, evaluated complication rate variation between different bariatric surgery programs.
Ibrahim et al, in a 2017 study, evaluated the 30-day complication rate for serious complications at 165 accredited bariatric surgery center of excellence programs nationwide. This study, of note, looked at serious complications that occurred after all weight loss operation (gastric bypass, gastric sleeve, LAP-BAND®), not just gastric bypass.
The authors found that the rate of serious complications occurring within 30 days of surgery varied 17-fold (yes, 17-fold!), from 0.6% to 10.3%, across the 165 different bariatric surgery center of excellence programs nationwide.
Our 30-day serious complication rate, using the same criteria and dates as in this study, is 0.6%.*
* Outcomes vary after weight loss surgery. Gastric bypass complications can happen. Past performance does not guarantee future results.
Late Gastric Bypass Complications
There is the potential for gastric bypass complications to develop long-term after gastric bypass surgery. Regular long-term follow-up is important after gastric bypass surgery to screen for potential complications. When complications develop, early diagnosis and treatment is important.
Possible long-term complications include vitamin/mineral deficiencies (common), bowel obstructions (2-3%), ulcers (5%), weight regain (10-30%), and alcohol abuse.