The management of bariatric surgery complications

Bariatric surgery is now commonplace in the UK and has been demonstrated to be safe and effective. Complications that present as an emergency are unusual but will be seen more frequently as the number of patients who have undergone weight loss surgery rises. However, the assessment and radiological imaging of a morbidly obese patient can be difficult to perform and interpret. It is therefore important for a general surgeon to have an understanding of the common bariatric procedures (gastric banding, gastric bypass, sleeve gastrectomy and duodenal switch) and their known complications. All general surgeons should know how to deflate a gastric band and know to suspect an internal hernia in a patient with abdominal symptoms following a gastric bypass or duodenal switch. It is also important to appreciate the significance of finding or suspecting there to be a gallstone in the common bile duct in patients who have had either of these bypass procedures. All bariatric centres in the UK should be able to provide specialist advice at any time. This advice should be sought at an early stage in the patient's care.