Skip to main content
SpringerLink
Log in

Peri-operative Management of the Bariatric Surgical Patient

  • Reference work entry
  • First Online:
Obesity, Bariatric and Metabolic Surgery

  • 95 Accesses

Abstract

Bariatric and metabolic surgery is becoming more common worldwide as a treatment for severe and complex obesity. Specific physiological and pathological factors may affect the perioperative outcome of these patients. Knowledge of these conditions and particular aspects of perioperative management will help to reduce the potential risks related to bariatric and metabolic surgery.

This chapter discusses the principles of perioperative care in patients undergoing bariatric or metabolic surgery. There is a focus on the evidence from relevant societal guidelines and the large-scale evidence syntheses to provide the reader with a structured, evidence-based approach to management strategies. The principles discussed here may help to provide a deeper understanding of the potential issues faced in perioperative management of patients receiving bariatric and metabolic surgery and may provide a basis to develop local management protocols to reduce perioperative risks.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 599.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 1,099.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Maciejewski ML, Arterburn DE, Van Scoyoc L, Smith VA, Yancy WS, Weidenbacher HJ, et al. Bariatric surgery and long-term durability of weight loss. JAMA Surg. 2016;151(11):1046.

    Article  Google Scholar 

  2. Wiggins T, Guidozzi N, Welbourn R, Ahmed AR, Markar SR. Association of bariatric surgery with all-cause mortality and incidence of obesity-related disease at a population level: a systematic review and meta-analysis. PLoS Med. 2020;17(7):e1003206.

    Article  Google Scholar 

  3. Sjöström L, Narbro K, Sjöström CD, Karason K, Larsson B, Wedel H, et al. Effects of bariatric surgery on mortality in Swedish Obese Subjects. N Engl J Med. 2007;357(8):741–52.

    Article  Google Scholar 

  4. Schauer PR, Bhatt DL, Kirwan JP, Wolski K, Brethauer SA, Navaneethan SD, et al. Bariatric surgery versus intensive medical therapy for diabetes – 3-year outcomes. N Engl J Med. 2014;370(21):2002–13.

    Article  Google Scholar 

  5. Singh P, Subramanian A, Adderley N, Gokhale K, Singhal R, Bellary S, et al. Impact of bariatric surgery on cardiovascular outcomes and mortality: a population-based cohort study. Br J Surg. 2020;107(4):432–42.

    Article  CAS  Google Scholar 

  6. Sjöström L, Gummesson A, Sjöström CD, Narbro K, Peltonen M, Wedel H, et al. Effects of bariatric surgery on cancer incidence in obese patients in Sweden (Swedish Obese Subjects Study): a prospective, controlled intervention trial. Lancet Oncol. 2009;10(7):653–62.

    Article  Google Scholar 

  7. Wiggins T, Antonowicz SS, Markar SR. Cancer risk following bariatric surgery—systematic review and meta-analysis of National Population-Based Cohort Studies. Obes Surg. 2019;29(3):1031–9.

    Article  Google Scholar 

  8. Tewksbury C, Crowley N, Parrott JM, Andromalos L, Isom KA, Smith E, et al. Weight loss prior to bariatric surgery and 30-day mortality, readmission, reoperation, and intervention: an MBSAQIP analysis of 349,016 cases. Obes Surg. 2019;29(11):3622–8.

    Article  Google Scholar 

  9. Rudasill SE, Morales RR, Sanaiha Y, Sareh S, Antonios JW, Khoury H, et al. Predicting morbidity and mortality in laparoscopic cholecystectomy: preoperative serum albumin still matters. Am J Surg. 2020;220(2):432–7.

    Article  Google Scholar 

  10. Griffiths EA, Hodson J, Vohra RS, Marriott P, Katbeh T, Zino S, et al. Utilisation of an operative difficulty grading scale for laparoscopic cholecystectomy. Surg Endosc. 2019;33(1):1–12.

    Google Scholar 

  11. Carron M, Safaee Fakhr B, Ieppariello G, Foletto M. Perioperative care of the obese patient. Br J Surg. 2020;107(2):e39–55.

    Article  CAS  Google Scholar 

  12. Itoh M, Suganami T, Hachiya R, Ogawa Y. Adipose tissue remodeling as homeostatic inflammation. Int J Inf Secur. 2011;2011:1–8.

    Google Scholar 

  13. Grundy SM, Brewer HB, Cleeman JI, Smith SC, Lenfant C. Definition of metabolic syndrome: report of the National Heart, Lung, and Blood Institute/American Heart Association conference on scientific issues related to definition. Circulation. 2004;24(2):e13–8.

    CAS  Google Scholar 

  14. Jung UJ, Choi MS. Obesity and its metabolic complications: the role of adipokines and the relationship between obesity, inflammation, insulin resistance, dyslipidemia and nonalcoholic fatty liver disease. Int J Mol Sci. 2014;15(4):6184–223.

    Article  Google Scholar 

  15. Després JP, Lemieux I. Abdominal obesity and metabolic syndrome. Nature. 2006;444(7121):881–7.

    Article  Google Scholar 

  16. Belligoli A, Compagnin C, Sanna M, Favaretto F, Fabris R, Busetto L, et al. Characterization of subcutaneous and omental adipose tissue in patients with obesity and with different degrees of glucose impairment. Sci Rep. 2019;9(1):11333.

    Article  Google Scholar 

  17. Grassi L, Kacmarek R, Berra L. Ventilatory mechanics in the patient with obesity. Anesthesiology. 2020;5:1246–56.

    Article  Google Scholar 

  18. Nightingale CE, Margarson MP, Shearer E, Redman JW, Lucas DN, Cousins JM, et al. Peri-operative management of the obese surgical patient 2015: Association of Anaesthetists of Great Britain and Ireland Society for Obesity and Bariatric Anaesthesia. Anaesthesia. 2015;70(7):859–76.

    Article  CAS  Google Scholar 

  19. Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea [Internet]. Lancet. 2014;383(9918):736–47.

    Article  Google Scholar 

  20. Wootton DM, Sin S, Luo H, Yazdani A, McDonough JM, Wagshul ME, et al. Computational fluid dynamics upper airway effective compliance, critical closing pressure, and obstructive sleep apnea severity in obese adolescent girls. J Appl Physiol. 2016;121(4):925–31.

    Article  CAS  Google Scholar 

  21. Roesslein M, Chung F. Obstructive sleep apnoea in adults. Eur J Anaesthesiol. 2018;35(4):245–55.

    Article  Google Scholar 

  22. Chung F, Memtsoudis SG, Ramachandran SK, Nagappa M, Opperer M, Cozowicz C, et al. Society of Anesthesia and Sleep Medicine guidelines on preoperative screening and assessment of adult patients with obstructive sleep apnea. Anesth Analg. 2016;123(2):452–73.

    Article  Google Scholar 

  23. Chau EHL, Lam D, Wong J, Mokhlesi B, Chung F. Obesity hypoventilation syndrome: a review of epidemiology, pathophysiology, and perioperative considerations [Internet]. Anesthesiology. 2012;117(1):188–205.

    Article  Google Scholar 

  24. Pouwels S, Buise MP, Twardowski P, Stepaniak PS, Proczko M. Obesity surgery and anesthesiology risks: a review of key concepts and related physiology. Obes Surg. 2019;29(8):2670–7.

    Article  Google Scholar 

  25. Alexander JK. The cardiomyopathy of obesity. Prog Cardiovasc Dis. 1985;27(5):325–34.

    Article  CAS  Google Scholar 

  26. Alpert MA, Karthikeyan K, Abdullah O, Ghadban R. Obesity and cardiac remodeling in adults: mechanisms and clinical implications. Prog Cardiovasc Dis. 2018;61(2):114–23.

    Article  Google Scholar 

  27. Alpert MA, Lavie CJ, Agrawal H, Aggarwal KB, Kumar SA. Obesity and heart failure: epidemiology, pathophysiology, clinical manifestations, and management. Transl Res. 2014;164(4):345–56.

    Article  CAS  Google Scholar 

  28. Good D, Morse SA, Ventura HO, Reisin E. Obesity, hypertension, and the heart. J Cardiometab Syndr. 2008;3(3):168–72.

    Article  Google Scholar 

  29. Lavie CJ, Pandey A, Lau DH, Alpert MA, Sanders P. Obesity and atrial fibrillation prevalence, pathogenesis, and prognosis: effects of weight loss and exercise. J Am Coll Cardiol. 2017;70(16):2022–35.

    Article  Google Scholar 

  30. Neeland IJ, Ross R, Després JP, Matsuzawa Y, Yamashita S, Shai I, et al. Visceral and ectopic fat, atherosclerosis, and cardiometabolic disease: a position statement. Lancet Diabet Endocrin. 2019;7(9):715–25.

    Article  Google Scholar 

  31. Yusuf S, Joseph P, Rangarajan S, Islam S, Mente A, Hystad P, et al. Modifiable risk factors, cardiovascular disease, and mortality in 155 722 individuals from 21 high-income, middle-income, and low-income countries (PURE): a prospective cohort study. Lancet. 2020;395(10226):795–808.

    Article  Google Scholar 

  32. Kahn SE, Cooper ME, Del Prato S. Pathophysiology and treatment of type 2 diabetes: perspectives on the past, present, and future. Lancet. 2014;383(9922):1068–83.

    Article  CAS  Google Scholar 

  33. Frisch A, Chandra P, Smiley D, Peng L, Rizzo M, Gatcliffe C, et al. Prevalence and clinical outcome of hyperglycemia in the perioperative period in noncardiac surgery. Diabetes Care. 2010;33(8):1783–8.

    Article  CAS  Google Scholar 

  34. Kotagal M, Symons RG, Hirsch IB, Umpierrez GE, Dellinger EP, Farrokhi ET, et al. Perioperative hyperglycemia and risk of adverse events among patients with and without diabetes. Ann Surg. 2015;261(1):97–103.

    Article  Google Scholar 

  35. Samad F, Ruf W. Inflammation, obesity, and thrombosis. Blood. 2013;122(20):3415–22.

    Article  CAS  Google Scholar 

  36. Helm MC, Simon K, Higgins R, Kindel TL, Gould JC. Perioperative complications increase the risk of venous thromboembolism following bariatric surgery. Am J Surg. 2017;214(6):1135–40.

    Article  Google Scholar 

  37. Rottenstreich A, Elazary R, Kalish Y. Abdominal thrombotic complications following bariatric surgery. Surg Obes Relat Dis. 2017;13(1):78–84.

    Article  Google Scholar 

  38. Vandiver JW, Ritz LI, Lalama JT. Chemical prophylaxis to prevent venous thromboembolism in morbid obesity: literature review and dosing recommendations. J Thromb Thrombolysis. 2016;41(3):475–81.

    Article  CAS  Google Scholar 

  39. Mechanick JI, Apovian C, Brethauer S, Garvey WT, Joffe AM, Kim J, et al. Clinical practice guidelines for the perioperative nutrition, metabolic, and nonsurgical support of patients undergoing bariatric procedures – 2019 update: cosponsored by American Association of Clinical Endocrinologists/American College of Endocrinology. Endocr Pract. 2019;25(12):1346–59.

    Google Scholar 

  40. Brill MJE, Diepstraten J, Van Rongen A, Van Kralingen S, Van Den Anker JN, Knibbe CAJ. Impact of obesity on drug metabolism and elimination in adults and children. Clin Pharmacokinet. 2012;51(5):277–304.

    Article  CAS  Google Scholar 

  41. Prado CMM, Heymsfield SB. Lean tissue imaging: a new era for nutritional assessment and intervention. J Parenter Enter Nutr. 2014;38(8):940–53.

    Article  Google Scholar 

  42. Cobbina E, Akhlaghi F. Non-alcoholic fatty liver disease (NAFLD)–pathogenesis, classification, and effect on drug metabolizing enzymes and transporters. Drug Metab Rev. 2017;49(2):197–211.

    Article  CAS  Google Scholar 

  43. Langeron O, Birenbaum A, Raux M. Airway management in obese patient [internet]. Minerva Med. 2014;80(3):382–92.

    CAS  Google Scholar 

  44. Petrini F, Giacinto IDI, Cataldo R, Esposito C, Donato P, Trolio A, et al. Perioperative and periprocedural airway management and respiratory safety for the obese patient: 2016 SIAARTI consensus perioperative and periprocedural airway management and respiratory safety for the obese patient: 2016 SIAARTI consensus. Minerva Anestesiol. 2016;82(12):1314–35.

    Google Scholar 

  45. Riad W, Vaez MN, Raveendran R, Tam AD, Quereshy FA, Chung F, et al. Neck circumference as a predictor of difficult intubation and difficult mask ventilation in morbidly obese patients. Eur J Anaesthesiol. 2016;33(4):244–9.

    Article  Google Scholar 

  46. Young J, Badgery-Parker T, Dobbins T, Jorgensen M, Gibbs P, Faragher I, et al. Comparison of ECOG/WHO performance status and ASA score as a measure of functional status. J Pain Symptom Manag. 2015;49(2):258–64.

    Article  Google Scholar 

  47. de Raaff CAL, Gorter-Stam MAW, de Vries N, Sinha AC, Jaap Bonjer H, Chung F, et al. Perioperative management of obstructive sleep apnea in bariatric surgery: a consensus guideline. Surg Obes Relat Dis. 2017;13(7):1095–109.

    Article  Google Scholar 

  48. Chung F, Yang Y, Liao P. Predictive performance of the stop-bang score for identifying obstructive sleep apnea in obese patients. Obes Surg. 2013;23(12):2050–7.

    Article  Google Scholar 

  49. Opperer M, Cozowicz C, Bugada D, Mokhlesi B, Kaw R, Auckley D, et al. Does obstructive sleep apnea influence perioperative outcome? A qualitative systematic review for the Society of Anesthesia and Sleep Medicine Task Force on preoperative preparation of patients with sleep-disordered breathing. Anesth Analg. 2016;122(5):1321–34.

    Article  Google Scholar 

  50. Mokhlesi B, Hovda MD, Vekhter B, Arora VM, Chung F, Meltzer DO. Sleep-disordered breathing and postoperative outcomes after elective surgery: analysis of the nationwide inpatient sample. Chest. 2013;144(3):903–14.

    Article  Google Scholar 

  51. Lukosiute A, Karmali A, Cousins JM. Anaesthetic preparation of obese patients: current status on optimal work-up. Curr Obes Rep. 2017;6(3):229–37.

    Article  Google Scholar 

  52. Virk JS, Kotecha B. When continuous positive airway pressure (CPAP) fails. J Thorac Dis. 2016;8(10):E1112–21.

    Article  Google Scholar 

  53. McCullough PA, Gallagher MJ, DeJong AT, Sandberg KR, Trivax JE, Alexander D, et al. Cardiorespiratory fitness and short-term complications after bariatric surgery. Chest. 2006;130(2):517–25.

    Article  Google Scholar 

  54. Hennis PJ, Meale PM, Hurst RA, O’Doherty AF, Otto J, Kuper M, et al. Cardiopulmonary exercise testing predicts postoperative outcome in patients undergoing gastric bypass surgery. Br J Anaesth. 2012;109(4):566–71.

    Article  CAS  Google Scholar 

  55. Moran J, Wilson F, Guinan E, Mccormick P, Hussey J, Moriarty J. Role of cardiopulmonary exercise testing as a risk-assessment method in patients undergoing intra-abdominal surgery: a systematic review. Br J Anaesth. 2016;109(4):566–71.

    Google Scholar 

  56. Gregson J, Kaptoge S, Bolton T, Pennells L, Willeit P, Burgess S, et al. Cardiovascular risk factors associated with venous thromboembolism. JAMA Cardiol. 2019;4(2):163–73.

    Article  Google Scholar 

  57. Keeling D, Tait RC, Watson H, British Committee of Standards for Haematology. Peri-operative management of anticoagulation and antiplatelet therapy. Br J Haematol. 2016;175(4):602–13.

    Article  Google Scholar 

  58. Hart A, Goffredo P, Carroll R, Lehmann R, Nau P, Smith J, et al. Optimizing bariatric surgery outcomes: the impact of preoperative elevated hemoglobin A1c levels on composite perioperative outcome measures. Surg Endosc. 2021;35(8):4618–23.

    Article  Google Scholar 

  59. Kwon S, Thompson R, Dellinger P, Yanez D, Farrohki E, Flum D. Importance of perioperative glycemic control in general surgery: a report from the surgical care and outcomes assessment program. Ann Surg. 2013;257(1):8–14.

    Article  Google Scholar 

  60. Kim JJ. Evidence base for optimal preoperative preparation for bariatric surgery: does mandatory weight loss make a difference? Curr Obes Rep. 2017;6(3):238–46.

    Article  Google Scholar 

  61. Tan SYT, Loi PL, Lim CH, Ganguly S, Syn N, Tham KW, et al. Preoperative weight loss via very low caloric diet (VLCD) and its effect on outcomes after bariatric surgery. Obes Surg. 2020;30(6):2099–107.

    Article  Google Scholar 

  62. Anderin C, Gustafsson UO, Heijbel N, Thorell A. Weight loss before bariatric surgery and postoperative complications: data from the Scandinavian Obesity Registry (SOReg). Ann Surg. 2015;261(5):909–13.

    Article  Google Scholar 

  63. Sun Y, Liu B, Smith JK, Correia MLG, Jones DL, Zhu Z, et al. Association of preoperative body weight and weight loss with risk of death after bariatric surgery. JAMA Network. 2020;3(5):3–11.

    Google Scholar 

  64. Holderbaum M, Casagrande DS, Sussenbach S, Buss C. Effects of very low calorie diets on liver size and weight loss in the preoperative period of bariatric surgery: a systematic review. Surg Obes Relat Dis. 2018;14(2):237–44.

    Article  Google Scholar 

  65. Thorell A, MacCormick AD, Awad S, Reynolds N, Roulin D, Demartines N, et al. Guidelines for perioperative care in bariatric surgery: enhanced recovery after surgery (ERAS) society recommendations. World J Surg. 2016;40(9):2065–83.

    Article  CAS  Google Scholar 

  66. Lyons NB, Bernardi K, Olavarria OA, Dhanani N, Shah P, Holihan JL, et al. Prehabilitation among patients undergoing non-bariatric abdominal surgery: a systematic review. J Am Coll Surg. 2020;231(4):480–9.

    Article  Google Scholar 

  67. Marc-Hernández A, Ruiz-Tovar J, Aracil A, Guillén S, Moya-Ramón M. Impact of exercise on body composition and cardiometabolic risk factors in patients awaiting bariatric surgery. Obes Surg. 2019;29(12):3891–900.

    Article  Google Scholar 

  68. DeMaria EJ, Portenier D, Wolfe L. Obesity surgery mortality risk score: proposal for a clinically useful score to predict mortality risk in patients undergoing gastric bypass. Surg Obes Relat Dis. 2007;3(2):134–40.

    Article  Google Scholar 

  69. DeMaria EJ, Murr M, Byrne TK, Blackstone R, Grant JP, Budak A, et al. Validation of the obesity surgery mortality risk score in a multicenter study proves it stratifies mortality risk in patients undergoing gastric bypass for morbid obesity. Ann Surg. 2007;246(4):578–82.

    Article  Google Scholar 

  70. Lorente L, Ramón JM, Vidal P, Goday A, Parri A, Lanzarini E, et al. Obesity surgery mortality risk score for the prediction of complications after laparoscopic bariatric surgery. Cir Esp. 2014;92(5):316–23.

    Article  Google Scholar 

  71. Sarela AI, Dexter SPL, McMahon MJ. Use of the obesity surgery mortality risk score to predict complications of laparoscopic bariatric surgery. Obes Surg. 2011;21(11):1698–703.

    Article  Google Scholar 

  72. Coblijn UK, Lagarde SM, de Raaff CAL, de Castro SM, van Tets WF, Jaap Bonjer H, et al. Evaluation of the obesity surgery mortality risk score for the prediction of postoperative complications after primary and revisional laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2016;12(8):1504–12.

    Article  Google Scholar 

  73. Major P, Wysocki M, Pędziwiatr M, Małczak P, Pisarska M, Migaczewski M. Can the obesity surgery mortality risk score predict postoperative complications other than mortality. Wideochir Inne Tech Maloinwazyjne. 2016;11(4):247–52.

    Google Scholar 

  74. García-García ML, Martín-Lorenzo JG, Lirón-Ruiz R, Torralba-Martínez JA, García-López JA, Aguayo-Albasini JL. Failure of the Obesity Surgery Mortality Risk Score (OS-MRS) to predict postoperative complications after bariatric surgery. A single-center series and systematic review. Obes Surg. 2017;27(6):1423–9.

    Article  Google Scholar 

  75. Sharma AM, Kushner RF. A proposed clinical staging system for obesity. Int J Obes. 2009;33(3):289–95.

    Article  CAS  Google Scholar 

  76. Skulsky SL, Dang JT, Battiston A, Switzer NJ, Birch DW, Sharma AM, et al. Higher Edmonton Obesity Staging System scores are associated with complications following laparoscopic Roux-en-Y gastric bypass. Surg Endosc. 2020;34(7):3102–9.

    Article  Google Scholar 

  77. Skulsky SL, Dang JT, Switzer NJ, Sharma AM, Karmali S, Birch DW, et al. Higher Edmonton Obesity Staging System scores are independently associated with postoperative complications and mortality following bariatric surgery: an analysis of the MBSAQIP. Surg Endosc. 2021;35(12):7163–73.

    Article  Google Scholar 

  78. Chiappetta S, Stier C, Squillante S, Theodoridou S, Weiner RA. The importance of the Edmonton Obesity Staging System in predicting postoperative outcome and 30-day mortality after metabolic surgery. Surg Obes Relat Dis. 2016;12(10):1847–55.

    Article  Google Scholar 

  79. Nickel F, De La Garza JR, Werthmann FS, Benner L, Tapking C, Karadza E, et al. Predictors of risk and success of obesity surgery. Obes Facts. 2019;12(4):427–39.

    Article  Google Scholar 

  80. Morgan DJR, Ho KM, Armstrong J, Baker S. Incidence and risk factors for intensive care unit admission after bariatric surgery: a multicentre population-based cohort study. Br J Anaesth. 2015;115(6):873–82.

    Article  CAS  Google Scholar 

  81. National Institute for Health and Care. Venous thromboembolism in over 16s: reducing the risk of hospital-acquired deep vein thrombosis or pulmonary embolism – NICE guideline [NG89]. 2018 Mar 21 [cited 18 10 2021]. Available from: https://www.nice.org.uk/guidance/ng89

  82. Haynes AB, Weiser TG, Berry WR, Lipsitz SR, Breizat A-HS, Dellinger EP, et al. A surgical safety checklist to reduce morbidity and mortality in a global population. N Engl J Med. 2009;360(5):491–9.

    Article  CAS  Google Scholar 

  83. Omar I, Madhok B, Parmar C, Khan O, Wilson M, Mahawar K. Analysis of National Bariatric Surgery Related Clinical Incidents: lessons learned and a proposed safety checklist for bariatric surgery. Obes Surg. 2021;31(6):2729–42.

    Article  Google Scholar 

  84. Booth CMA, Moore CE, Eddleston J, Sharman M, Atkinson D, Moore JA. Patient safety incidents associated with obesity: a review of reports to the National Patient Safety Agency and recommendations for hospital practice. Postgrad Med J. 2011;87(1032):694–9.

    Article  CAS  Google Scholar 

  85. National Audit Projects. 5th National Audit Project of the Royal College of Anaesthetists and the Association of Anaesthetists of Great Britain and Ireland: Accidental awareness during general anaesthesia in the United Kingdom and Ireland. Report and findings. 2014 Sep [cited 18 10 2021]. Available from: https://www.nationalauditprojects.org.uk/downloads/NAP5%20full%20report.pdf

  86. National Audit Projects. 4th National Audit Project of the Royal College of Anaesthetists and The Difficult Airway Society: Major Complications of Airway management in the United Kingdom. Report and Findings. 2011 Mar [cited 18 10 2021]. Available from: https://www.nationalauditprojects.org.uk/downloads/NAP4%20Full%20Report.pdf

  87. Aftab H, Fagerland MW, Gondal G, Ghanima W, Olsen MK, Nordby T. Pain and nausea after bariatric surgery with total intravenous anesthesia versus desflurane anesthesia: a double blind, randomized, controlled trial. Surg Obes Relat Dis. 2019;15(9):1505–12.

    Article  Google Scholar 

  88. Winfield R, Reese S, Bochicchio K, Mazuski JE, Bochicchio GE. Obesity and the risk for surgical site infection in abdominal surgery. Am Surg. 2016;82(4):331–6.

    Article  Google Scholar 

  89. Fischer MI, Dias C, Stein A, Meinhardt NG, Heineck I. Antibiotic prophylaxis in obese patients submitted to bariatric surgery. A systematic review. Acta Cir Bras. 2014;29(3):209–17.

    Article  Google Scholar 

  90. Chen X, Brathwaite CEM, Barkan A, Hall K, Chu G, Cherasard P, et al. Optimal cefazolin prophylactic dosing for bariatric surgery: no need for higher doses or intraoperative redosing. Obes Surg. 2017;27(3):626–9.

    Article  Google Scholar 

  91. Bartlett MA, Mauck KF, Daniels PR. Prevention of venous thromboembolism in patients undergoing bariatric surgery. Vasc Health Risk Manag. 2015;11:461–77.

    Google Scholar 

  92. Venclauskas L, Maleckas A, Arcelus JI. European guidelines on perioperative venous thromboembolism prophylaxis. Eur J Anaesthesiol. 2018;35(2):147–53.

    Article  Google Scholar 

  93. Welbourn R, Hollyman M, Kinsman R, Dixon J, Liem R, Ottosson J, et al. Bariatric surgery worldwide: baseline demographic description and one-year outcomes from the Fourth IFSO Global Registry Report 2018. Obes Surg. 2019;29(3):782–95.

    Article  Google Scholar 

  94. Alizadeh RF, Li S, Inaba C, Penalosa P, Hinojosa MW, Smith BR, et al. Risk factors for gastrointestinal leak after bariatric surgery: MBASQIP analysis. J Am Coll Surg. 2018;227(1):135–41.

    Article  Google Scholar 

  95. De Robertis E, Marinosci GZ, Romano GM, Piazza O, Iannuzzi M, Cirillo F, et al. The use of sugammadex for bariatric surgery: analysis of recovery time from neuromuscular blockade and possible economic impact. Clin Outcomes Res. 2016;8:317–22.

    Article  Google Scholar 

  96. Bamgbade OA, Oluwole O, Khaw RR. Perioperative analgesia for fast-track laparoscopic bariatric surgery. Obes Surg. 2017;27(7):1828–34.

    Article  Google Scholar 

  97. Lee Y, Yu J, Doumouras AG, Ashoorion V, Gmora S, Anvari M, et al. Intravenous acetaminophen versus placebo in post-bariatric surgery multimodal pain management: a meta-analysis of randomized controlled trials. Obes Surg. 2019;29(4):1420–8.

    Article  Google Scholar 

  98. 'Pournaras DJ, Osborne A, Hawkins SC, Vincent RP, Mahon D, Ewings P, et al. Remission of type 2 diabetes after gastric bypass and banding: mechanisms and 2 year outcomes. Ann Surg. 2010;252(6):966–71.

    Article  Google Scholar 

  99. Sudlow A, le Roux CW, Pournaras DJ. Review of multimodal treatment for type 2 diabetes: combining metabolic surgery and pharmacotherapy. Ther Adv Endocrinol Metab. 2019;23(10):2042018819875407.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Upper GI unit, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

    Tom Wiggins

  2. Homerton University Hospital, London, UK

    Miriam Adebibe & John Loy

Authors
  1. Tom Wiggins
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Miriam Adebibe
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. John Loy
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to John Loy .

Editor information

Editors and Affiliations

  1. Homerton University Hospital, London, UK

    Sanjay Agrawal

Section Editor information

  1. Department of General Surgery, University Hospital Lewisham, London, UK

    Cynthia-Michelle Borg MD (Malta), MD (London), FRCS

Rights and permissions

Reprints and permissions

Copyright information

© 2023 Springer Nature Switzerland AG

About this entry

Check for updates. Verify currency and authenticity via CrossMark

Cite this entry

Wiggins, T., Adebibe, M., Loy, J. (2023). Peri-operative Management of the Bariatric Surgical Patient. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-60596-4_17

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-60596-4_17

  • Published:

  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-60595-7

  • Online ISBN: 978-3-030-60596-4

  • eBook Packages: MedicineReference Module Medicine

Publish with us

Policies and ethics

Search

Navigation