Complications and Risks: Duodenal Switch

Complications and Risks: Duodenal Switch

Typically performed only when there has been a failed attempt at gastric banding, duodenal switch weight loss surgery reduces the size of the stomach and also re-directs the flow of food. This helps the individual to lose weight through both malabsorption of calories and nutrients and restriction of the amount of food that can go into the stomach.

Duodenal Switch

Short Term Complications and Risks

As with any major surgery there are related risks and complications that may occur. You will want to discuss these possible risks with your physician before you decide if the surgery is the best for your situation. Weighing the options before hand is an important part of the process. Some of the potential short term complications and risks may include:

  • Blood clots;
  • Excessive bleeding;
  • Infection;
  • Difficulty with liquid consumption following surgery;
  • Swelling around the stomach and small bowel causing dehydration;
  • Leakage in the stomach;
  • In rare cases, death.

Long Term Complications and Risks

The potential long term complications and risks might include:

  • Brittle bones/osteoporosis as a result of malabsorption of calcium and vitamin D;
  • Nutritional deficiencies;
  • Chronic diarrhea (caused by dumping syndrome);
  • Gas and stools that is foul-smelling;
  • Easy absorption of carbohydrates causing weight gain;
  • Higher risk of pneumonia.

Risks with Duodenal Switch Surgery

There are many risks associated with duodenal switch weight loss surgery. While the surgery is extremely effective in helping patient lose weight, they must continue to eat a healthy diet in order to remain healthy. Some common risks associated with all weight loss surgeries include infection at the incision site, anemia, osteoporosis, gallstones, pulmonary embolism, injury to the spleen, kidney failure and deep vein thrombosis (blood clots in the legs). Dumping syndrome, a condition where patients may feel nauseous, vomit, feel faint, have excessive perspiration and/or have chronic diarrhea is common in weight loss surgery patients. The higher risk of osteoporosis occurs because the body cannot absorb nutrients effectively. Diarrhea often occurs because of the poor absorption of iron, fat, protein and many vitamins including B12, A, D, E and K. Bowel obstructions can also occur.

To reduce your overall risks for this weight loss surgical procedure, inform your doctor of any vitamins or medications you are taking before surgery. Also, stop taking them when directed before surgery. Most importantly, do not smoke at least two weeks before your surgery and never after as this will slow the overall healing process. Remember to take any antibiotics and follow all aftercare instructions closely. Look for side effects quickly as this will prevent any more serious complications that could have been treated or avoided from occurring.

Common Complications Associated with Duodenal Switch Surgery

Ultimately, the amount of risk that a surgery in particular a weight loss surgery has depends on how extensive the procedure is. Duodenal switch surgery is a complex medical surgery and procedure. However, any surgery can lead to a number of complications if patients are not careful or treated properly.

This aggressive surgical procedure can result in a series of complications. Patients will learn of these complications during their initial consultation and will be reminded of them throughout the process leading up to their duodenal switch surgery.

  • Vitamin Deficiencies

    Some of the most important vitamins (A, D, E & K as well as calcium) become harder to absorb due to the new way food is absorbed in patients. The malabsorptive technique used in surgery can create these ailments. While this may promote fast weight loss, it can lead to many issues too. If these deficiencies go untreated, they can affect the entire nervous system. This is why regular blood work and labs is imperative in order to maintain optimal health following duodenal switch surgery. Some patients may experience some hair loss associated with these deficiencies.

    According to John Hopkins Hospital, protein deficiency (anemia) occurs in about 18% of patients too. If the condition becomes severe (kwashiorkor), it can be life threatening. Also, a thiamine deficiency (beriberi) is common and can damage the nervous system if not treated.

  • Gastroesophageal Reflux Disease or GERD

     This medical condition is caused when acid in the stomach backs up into the esophagus, which can cause discomfort and a burning sensation known as heartburn. Many patients will experience these GERD symptoms before surgery and many will occur following surgery as well because of the rerouting technique used. Excess gas is caused by eating too many carbs and with this surgery and a new diet, many symptoms disappear.  
  • Bowel Changes

    Many patients will experience frequent and loose bowel movements several times a day the day. They may also have foul-smelling gas and frequent flatulence. This can be treated by watching the foods ones eat as well as learning which trigger foods cause these symptoms. These symptoms can also be caused by lactose intolerance. Also, diarrhea can occur for those who are eating too many fats and can occur following surgery because of the new way the body absorbs food.  
  • Blood Clots or Leaks

     Ultimately, any surgical procedure that uses stitches in the stomach or intestines runs the risk of leaks. Bleeding or blood clots is also a potential risk or complication with duodenal switch surgery.  
  • Liver or Spleen Injury

     During an intense weight loss surgical procedure such as duodenal switch surgery, the liver or spleen can be injured. In extreme cases, the spleen itself has to be removed entirely.  
  • Changes in Body Odor

    Many patients experience a change in the way their body smells. This is because of the way the body is absorbing nutrients now. 
  • Other Potential Complications with Duodenal Switch Surgery

     During surgery, bleeding or organ damage can occur. Immediately following surgery, a patient can also experience abscess, infection, bowel obstruction or perforation, pancreatitis or even pneumonia (a patient’s risk is higher for 10+ years following weight loss surgery). Some long-term complications include: hernia, anemia, kidney stones, gallstones, osteoporosis and kidney stones. Many patients have their gallbladders removed during weight loss surgery procedures to prevent future pain and issues.

Wrong Turns on the Road to Success

Duodenal switch surgery is a serious surgery that requires a fair amount of recovery time. The three to four weeks of recovery time is only the start of the process. The long term prognosis for most individuals that participate in the surgery is good, if they follow the guidelines and suggestions of the medical team. Making sure that you are getting proper nutrition is vital during the process. It is for this reason that physicians insist patients learn all about nutrition and which foods are the best to eat during the process. Since the stomach is so much smaller it is vital that only useful foods take up the small amount of space.

Related: What is Duodenal Switch Success Look Like? – ObesityReporter

Duodenal Switch Psychological Complications

Along with the medical complications and risks there are some psychological considerations to be made. Many patients that go through weight loss surgery and lose a substantial amount of weight quickly will go through a period of adjustment. The lifestyle changes and the new body is a lot to handle for some patients. While most families and friends will be extremely supportive, there are some that will not. Dealing with this can make it hard to be successful for some patients. In some cases it is a good idea for the patient to meet with a therapist or visit with a support group to learn how to cope with the many changes that they are facing.

While there are complications and risks involved in duodenal switch surgery, for many the potential for success far outweighs the risks. Making sure that all of the facts are brought out in the open before you decide is essential to the success of the surgery. Ask all of the questions that you might have before you decide and make sure that you are committed to the lifestyle changes following the surgery.

Ultimately, while you can be aware of the risks and complications associated with duodenal switch surgery, you never can be completely protected from their onset. It is extremely difficult for surgeons to determine which side effects will occur with each patient. This makes being conscious of these risks even more important.