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. The optimal management encompasses a low threshold of suspicion and early diagnosis of complications coupled with expertise to deal with them. 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), their known complications and when to refer to a specialist centre. 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 bariatric surgery. 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 the 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.