15
Complications
Early (First 30 Days)
➤ General post-operative complications
• Nausea/vomiting
• Dehydration
• Wound infection
• Cardiac dysrhythmias
• Deep vein thrombosis and/or pulmonary embolism
• Atelectasis and pneumonia
➤ Bleeding at the surgical site or rarely intraluminal/gastrointestinal
(RNY, sleeve gastrectomy, BPD/DS)
• Usually within 72 hours post-op, may require early intervention or
reoperation.
• Symptoms: tachycardia, hypotension, drop in hemoglobin/
hematocrit, oliguria.
• From three to seven days out, cause is more likely due to erosions
and ulcerations at the anastomoses or along staple lines.
➤ Leak or perforation (RNY, sleeve gastrectomy, BPD/DS)
• Can lead to acute peritonitis.
• Technical failure within the f irst 72 hours (with ischemia can occur
up to 14 days post-op).
• Can also occur at any time due to ulcer perforation (avoid
nonsteroidal anti-inflammatory drugs [NSAIDS], steroids, nicotine,
caffeine, alcohol).
• Often with acute and severe abdominal pain (may not have
peritonitis symptoms if on steroids).
• Fever, tachycardia, abdominal or back pain, and leukocytosis.
• Urgent surgical exploration may be required but can sometimes
be managed with endoscopic stent and drain (in selected cases)
• Imaging not always diagnostic but when performed, water soluble
contrast preferred (abdominal CT or upper GI).
• Immediate surgical consultation is critical for suspected leak or
perforation even if imaging is negative.
