Why sleeve gastrectomy is not recommended
Nov 05, 2024
Source: Cainiu Health
Dr. Shen Yonghua
Introduction
In general, sleeve gastrectomy may not be recommended due to factors such as body mass index not meeting the criteria, psychological and behavioral issues, malnutrition, coagulation disorders, or gastrointestinal ulcers. Before deciding whether to undergo sleeve gastrectomy, it is important to consult a specialized bariatric surgeon and carefully weigh the surgical risks against potential benefits through a comprehensive evaluation.
In general, sleeve gastrectomy may not be recommended due to factors such as body mass index (BMI) not meeting criteria, psychological and behavioral issues, malnutrition, coagulation disorders, or gastrointestinal ulcers. If discomfort occurs, immediate medical consultation is advised. Detailed explanations are as follows:
1. Body Mass Index Not Meeting Criteria
Patients with a BMI below 35 are generally not advised to undergo sleeve gastrectomy, as the surgical risks may outweigh the benefits, and postoperative weight loss may be limited. These patients are better suited for non-surgical weight management methods such as dietary control, regular exercise, and behavioral therapy, which are safe, cost-effective, and avoid surgical risks.
2. Psychological and Behavioral Issues
Patients with severe psychological conditions such as depression or anxiety, or unhealthy eating behaviors like binge eating or emotional eating, may experience suboptimal surgical outcomes. Additionally, psychological and behavioral problems can interfere with postoperative dietary and lifestyle changes, leading to unsatisfactory results. Doctors or mental health professionals can provide counseling and guidance to help patients manage psychological stress associated with surgery.
3. Malnutrition
After sleeve gastrectomy, the significantly reduced stomach capacity may impair absorption of certain nutrients, such as vitamin B12, iron, and calcium, potentially leading to long-term complications like anemia and osteoporosis. It is recommended to supplement the diet with foods rich in vitamins and minerals, such as fresh vegetables, fruits, and whole grains.
4. Coagulation Disorders
Coagulation disorders typically result from impaired synthesis or function of clotting factors, leading to bleeding tendencies or abnormal clotting. Patients with such conditions are at increased risk of uncontrollable bleeding during and after surgery, raising the likelihood of surgical complications. Symptoms may include subcutaneous bruising and gum bleeding. Treatment under medical supervision may include medications such as nadroparin calcium injection, heparin sodium tablets, or Guifu Dihuang Pills.
5. Gastrointestinal Ulcers
Gastrointestinal ulcers are primarily caused by Helicobacter pylori infection or long-term use of nonsteroidal anti-inflammatory drugs (NSAIDs). Performing sleeve gastrectomy on patients with existing ulcers increases the risk of ulcer perforation or bleeding, thereby increasing surgical risks. Common symptoms include upper abdominal pain, nausea, and vomiting. Treatment may include medications such as lansoprazole enteric-coated tablets, omeprazole enteric-coated capsules, or ranitidine hydrochloride capsules, as prescribed by a physician.
Prior to undergoing any weight-loss surgery, patients should consult with a qualified physician, comprehensively evaluate their individual health status and surgical risks, and make informed decisions under professional medical guidance.
