Evaluation of risk factors for complications after bariatric surgery.
Fiche publication
Date publication
mars 2018
Journal
Journal of visceral surgery
Auteurs
Membres identifiés du Cancéropôle Est :
Pr QUILLIOT Didier
Tous les auteurs :
Quilliot D, Sirveaux MA, Nomine-Criqui C, Fouquet T, Reibel N, Brunaud L
Lien Pubmed
Résumé
The decision to perform a bariatric surgical procedure, the conclusion of a clinical pathway in which management is individually adapted to each patient, is taken after multidisciplinary consultation. Paradoxically, the patients who would most benefit from surgery are also those who have the highest operative risk. In practice, predictive factors of mortality and severe postoperative complications (Clavien-Dindo>III) must be used to evaluate the benefit/risk ratio most objectively. The main risk factors are age, male gender, body mass index, obstructive sleep apnea syndrome, insulin resistance and diabetes, tobacco abuse, cardiovascular disease, ability to lose weight before surgery, hypoalbuminemia and functional disability. Routine preoperative evaluation of high perioperative risk patients provides the attending physician with information to: (1) correct several of these risk factors before surgery and thereby limit the operative risk; (2) orient the patient to a less risky surgical procedure and/or to a facility with a more adapted technical capacity, as necessary; (3) contra-indicate the operation if the risks exceed the expected benefits. All in all, this preoperative evaluation combined with management of comorbidities contributes to decrease the risk of postoperative complications and to improve the overall management of obese patients.
Mots clés
Bariatric surgery, Gastric bypass, Obesity surgery, Postoperative complications, Risk factors, Sleeve gastrectomy
Référence
J Visc Surg. 2018 Mar 26;: