Table 2.
Complications seen with all the three procedures
| LAGB | LRYGB | SADS |
|---|---|---|
| Early | Early | Early |
| Pneumonia-1 | Pneumonia-1 | Acute cholecystitis, sub hepatic abcess-1i |
| Reflux-1 | Wound infection-1 | Wound infection-1 |
| Stricture-1e | Gastro cutaneous fistula-1j | |
| Leak and abcess-1f | ||
| Total early complication rate-8.3 % | Total early complication rate-28.5 % | Total early complication rate-20 % |
| Late | Late | Late |
| Nausea and vomiting-5a | Stricture-1g | Diarrhea-2k |
| Reflux-3b | Reflux-2h | Stricture needing dilation-1 |
| Weight regain-4 | Chronic diarrhea-1 | |
| Slipped lap band-2c | ||
| Erosion of lap band port-1d | ||
| Total late complication rate-62.5 % | Total late complication rate-28.5 % | Total late complication rate-20 % |
LAGB laparoscopic gastric banding, LRYGB laparoscopic Roux-en-Y gastric bypass, SADS single anastomosis duodenal switch
In LAGB group
aAll the 5 patient had nausea and vomiting because of band being too tight. All of them got their band adjusted
bOne of the patient had severe reflux, couldn’t keep any food down and, needed a larger band replacement
cOne of the patient with slipped band had inverted port 2 years later and needed the band removal
dPatient with the erosion of lap band port needed the surgery for the exchange of lap band port for low profile port
In LRYGB group
eOne patient complained of GERD and underwent EGD. EGD showed stricture at the gastric outlet obstruction requiring dilation
fThis patient had history of multiple abdominal surgeries who underwent elective LRYGB, left inguinal hernia repair and hiatal hernia repair. Intraoperatively, patient had bladder perforation requiring bladder reconstruction. On post-operative day 1, patient developed intra-abdominal leak with bile noted on JP drain. Patient was taken back to the operating room and underwent exploratory laparotomy with incision and drainage, removal of abdominal mesh, and partial omentectomy due to marginally vascularized omentum. Patient was transferred to intensive care unit (ICU) and was extubated. On post-operative day 10, patient developed sepsis and abdominal abscess. Patient was treated with antibiotics and was placed on total parental nutrition (TPN) because of severe malnutrition. At last, patient developed acute renal insufficiency secondary to pre-renal azotemia. Patient got discharged after 17 days and was transferred to rehab for recovery
gThis patient complained of progressive dysphagia, who also underwent EGD which showed Gastrojejunal (GJ) stricture needing dilation. This patient after 1 year developed ulcers and fistula and underwent revision of GJ anastomosis
hOne of the 2 patients who complained of reflux also had severe abdominal pain. EGD showed hiatal hernia and bifid gastric pouch. Patient underwent hiatal hernia repair with mesh and partial gastrectomy
In SADS group
iThis patient had acute cholecystitis and sub hepatic abscess needing re-admission within 30 days of discharge. The patient underwent cholecystectomy and drainage of abscess
jThis is the second patient who needed re-admission within 30 days of discharge for the treatment of gastro cutaneous fistula
kOne of the patients had chronic diarrhea, excessive weight loss, and hypoalbuminemia requiring common channel lengthening approximately 1 year after SADS