SHM's Clinical Quick Talks-Care of the Post-Bariatric Surgery Patient: What I Should Know Even if I Am Not a Bariatric Surgeon

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This article provides an overview of post-bariatric surgery care for non-bariatric surgeons. It outlines the indications and contraindications for bariatric surgery and describes the different types of surgeries and their complications. It also discusses the specificities and management of a bariatric surgery patient admitted to the hospital. The article emphasizes the importance of understanding post-surgical complications and the role of hospitalists and other non-bariatric surgery clinicians in managing these patients.<br /><br />Surgical candidates for bariatric surgery have a BMI of 40 Kg/m2 or BMI 35-40 Kg/m2 with serious comorbidities. The article also mentions controversial cases where patients with a BMI of 30-35 Kg/m2 and serious comorbidities may be considered for surgery, but evidence is lacking.<br /><br />Psychiatric diseases, substance abuse, extremes of age, and medical contraindications are factors that may make patients ineligible for bariatric surgery. The article describes the different surgical techniques, including laparoscopic adjustable gastric band, sleeve gastrectomy, Roux-en-Y gastric bypass, and biliopancreatic diversion with duodenal switch. Each surgery has specific complications and considerations.<br /><br />The article highlights the importance of recognizing late surgical complications that may present as medical problems. It discusses medical complications such as increased risk of gallstones, dumping syndrome, excessive weight loss, vitamin deficiency, fractures, and osteomalacia.<br /><br />The article also provides specific considerations for medications in post-bariatric surgery patients and includes a case study illustrating the diagnosis of dumping syndrome. Clinical pearls are mentioned, including the use of CT scans and surgical exploration to rule out complications, the role of hormonal changes in the rapid improvement of diabetes after surgery, and the use of ursodiol to prevent cholelithiasis.<br /><br />In conclusion, the article emphasizes the important role of hospitalists and non-bariatric surgeons in managing post-bariatric surgery patients and advises them to be vigilant in recognizing complications.

Asset Subtitle

Samer Badr

Keywords

post-bariatric surgery care

non-bariatric surgeons

indications

contraindications

types of surgeries

complications

bariatric surgery patient

hospitalists

post-surgical complications

surgical candidates