14
Contraindications and Risk Assessment
Late Complications (Months to Years Post-Op)
Complication
Associated
Procedures Signs/Symptoms Comments
Marginal ulcer RNYGB Epigastric pain,
nausea, anemia,
gastrointestinal
(GI) bleeding
Proton pump
inhibitors
(PPIs), eliminate
nonsteroidal
antiinflammatory
drugs (NSAIDs)/
tobacco
Internal
hernia
RNYGB Intermittent
colicky pain,
nausea,
obstruction
Urgent imaging
and surgical repair
Cholelithiasis All Right upper
quadrant
(RUQ) pain,
postprandial
discomfort
Common after
rapid weight loss;
cholecystectomy if
symptomatic
Nutritional
deficiencies
RNYGB, BPD/
DS, SADI-S
Fatigue,
neuropathy, hair
loss, brittle nails
Annual labs
and lifelong
supplementation
Hypoglycemia RNYGB Dizziness,
confusion,
tremors,
postprandial
events
Managed with
dietary strategies
+/– medication
Weight
regain
All Weight gain,
loss of satiety,
increased
hunger
Behavioral
and anatomic
evaluation
recommended
