Skip to main content

Main menu

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums

User menu

  • My alerts

Search

  • Advanced search
The College of Family Physicians of Canada
  • Other Publications
    • http://www.cfpc.ca/Canadianfamilyphysician/
    • https://www.cfpc.ca/Login/
    • Careers and Locums
  • My alerts
The College of Family Physicians of Canada

Advanced Search

  • Home
  • Articles
    • Current
    • Published Ahead of Print
    • Archive
    • Supplemental Issues
    • Collections - French
    • Collections - English
  • Info for
    • Authors & Reviewers
    • Submit a Manuscript
    • Advertisers
    • Careers & Locums
    • Subscribers
    • Permissions
  • About CFP
    • About CFP
    • About the CFPC
    • Editorial Advisory Board
    • Terms of Use
    • Contact Us
  • Feedback
    • Feedback
    • Rapid Responses
    • Most Read
    • Most Cited
    • Email Alerts
  • Blogs
    • Latest Blogs
    • Blog Guidelines
    • Directives pour les blogues
  • Mainpro+ Credits
    • About Mainpro+
    • Member Login
    • Instructions
  • RSS feeds
  • Follow cfp Template on Twitter
  • LinkedIn
  • Instagram
Review ArticlePractice

Bariatric surgery

A primer

Shahzeer Karmali, Carlene Johnson Stoklossa, Arya Sharma, Janet Stadnyk, Sandra Christiansen, Danielle Cottreau and Daniel W. Birch
Canadian Family Physician September 2010; 56 (9) 873-879;
Shahzeer Karmali
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • For correspondence: shahzeer@ualberta.ca
Carlene Johnson Stoklossa
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Arya Sharma
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Janet Stadnyk
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Sandra Christiansen
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Danielle Cottreau
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
Daniel W. Birch
  • Find this author on Google Scholar
  • Find this author on PubMed
  • Search for this author on this site
  • Article
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF
Loading
Submit a Response to This Article
Compose eLetter

More information about text formats

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
Author Information
First or given name, e.g. 'Peter'.
Your last, or family, name, e.g. 'MacMoody'.
Your email address, e.g. higgs-boson@gmail.com
Your role and/or occupation, e.g. 'Orthopedic Surgeon'.
Your organization or institution (if applicable), e.g. 'Royal Free Hospital'.
Statement of Competing Interests
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Image CAPTCHA
Enter the characters shown in the image.

Vertical Tabs

Jump to comment:

  • Tara Bloom
    Published on: 06 October 2010
  • Response to Grossly Inadequate Complications
    Shahzeer Karmali
    Published on: 04 October 2010
  • Grossly Inadequate List of Complications
    Robert J smith
    Published on: 03 October 2010
  • Shahzeer Karmali
    Published on: 23 September 2010
  • Rapid response
    Tsering C Dorjee
    Published on: 23 September 2010
  • Published on: (6 October 2010)
    Page navigation anchor for
    • Tara Bloom, family doctor

    In your conclusions it states that frequent meals - 3meals and 2 snacks is required by patients post surgery. It also states that patients should eat slowly. This contradicts your early statements about risk factors for weight gain, namely frequent snacks and eating slowly. I was impressed by your detailed explanation of complications with each procedure. i find it is difficult to find such thorough information. Most in...

    Show More

    In your conclusions it states that frequent meals - 3meals and 2 snacks is required by patients post surgery. It also states that patients should eat slowly. This contradicts your early statements about risk factors for weight gain, namely frequent snacks and eating slowly. I was impressed by your detailed explanation of complications with each procedure. i find it is difficult to find such thorough information. Most information is about the actual details of the procedure. However, for a family doctor the most relevant information is how it will affect patient, not exactly how the procedure is completed.

    Show Less
    Competing Interests: None declared.
  • Published on: (4 October 2010)
    Page navigation anchor for Response to Grossly Inadequate Complications
    Response to Grossly Inadequate Complications
    • Shahzeer Karmali

    The list of complications provided represent those most commonly encountered by bariatric surgeons. With surgical practice outliers are possible.

    In regards to the issues brought up. Firstly, many patients are misinformed of the procedure they have done. We run a revisional clinic in Edmonton and I get referrals daily about individuals who have had an bypass and are having problems. Many of these especially thos...

    Show More

    The list of complications provided represent those most commonly encountered by bariatric surgeons. With surgical practice outliers are possible.

    In regards to the issues brought up. Firstly, many patients are misinformed of the procedure they have done. We run a revisional clinic in Edmonton and I get referrals daily about individuals who have had an bypass and are having problems. Many of these especially those who are having the extensive nutritional deficiencies, have not had a Roux en Y bypass but rather an Jejuno-ileal bypass, which as we mention in the article is no longer performed because of these issues. For the Roux en Y with an informed patient, malnutrition should not be an issue.

    The wound infection and other issues you mention have changed substantially since the introduction of laparoscopic surgery which has revolutionized bariatric care. The numbers published are those of best evidences based practice.

    If we can be of any help to your patients please let us know

    SK

    Show Less
    Competing Interests: None declared.
  • Published on: (3 October 2010)
    Page navigation anchor for Grossly Inadequate List of Complications
    Grossly Inadequate List of Complications
    • Robert J smith, MD

    I thought that the summary was far to "rose colored" for my patient's experience. I've had patients that have had roux-en-y gastrectomies since nearly 40 years ago. Many of them have been quite ill with comorbid conditions, female and seemingly perfect candidates. Their long term complications include:

    Chronic protein/vitamin malnutrition (pt done 40y ago in Edmonton for Obesity) Severe depression (pt done in s...

    Show More

    I thought that the summary was far to "rose colored" for my patient's experience. I've had patients that have had roux-en-y gastrectomies since nearly 40 years ago. Many of them have been quite ill with comorbid conditions, female and seemingly perfect candidates. Their long term complications include:

    Chronic protein/vitamin malnutrition (pt done 40y ago in Edmonton for Obesity) Severe depression (pt done in small hospital program prior to surgery for malignant brain tumor) Late surgical skin infection (severe diabetes with complications, after nearly 2 years of aggressive would care she still has not been able to return to work).

    Not one of the above patients would have the surgery again if suggested.

    Further, I'd suggest that combined early and late mortality rates compared to the mortality rates of the comorbid illnesses is far higher than the 1-3% quoted here. Also, a fairly large percentage of severely obese patients in my practice do NOT undertake a healthy lifestyle before surgery, although they may claim that they do. Careful inquiry reveals inadequate exercise and excessive empty calories despite multi-disciplinary aggressive counseling. It CAN be a good surgery, but it's nothing like a panacea for severe obesity.

    Show Less
    Competing Interests: None declared.
  • Published on: (23 September 2010)
    Page navigation anchor for
    • Shahzeer Karmali

    Gallstones post bariatric surgery are a function of the rapidity of weight loss after the procedure has been performed. Patients who lose weight rapidly after bariatric surgery are more at risk of forming gallstones. Gallstones, themselves are not a large issue. The major problem develops if the patient has had a Roux en Y bypass and develops choledocholithiasis, as it is quite difficult to access the common bile duct e...

    Show More

    Gallstones post bariatric surgery are a function of the rapidity of weight loss after the procedure has been performed. Patients who lose weight rapidly after bariatric surgery are more at risk of forming gallstones. Gallstones, themselves are not a large issue. The major problem develops if the patient has had a Roux en Y bypass and develops choledocholithiasis, as it is quite difficult to access the common bile duct endoscopically as the anatomy has been re-arranged. The only route to access the CBD is via percutaneous gastrotomy.

    Show Less
    Competing Interests: None declared.
  • Published on: (23 September 2010)
    Page navigation anchor for Rapid response
    Rapid response
    • Tsering C Dorjee, family physician
    I have seen cases of gall stones post- bariatric surgery during my residency. Would fluid restriction have a role in the etiology?
    Competing Interests: None declared.
PreviousNext
Back to top

In this issue

Canadian Family Physician: 56 (9)
Canadian Family Physician
Vol. 56, Issue 9
1 Sep 2010
  • Table of Contents
  • About the Cover
  • Index by author
Print
Download PDF
Article Alerts
Sign In to Email Alerts with your Email Address
Email Article

Thank you for your interest in spreading the word on The College of Family Physicians of Canada.

NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address.

Enter multiple addresses on separate lines or separate them with commas.
Bariatric surgery
(Your Name) has sent you a message from The College of Family Physicians of Canada
(Your Name) thought you would like to see the The College of Family Physicians of Canada web site.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
Citation Tools
Bariatric surgery
Shahzeer Karmali, Carlene Johnson Stoklossa, Arya Sharma, Janet Stadnyk, Sandra Christiansen, Danielle Cottreau, Daniel W. Birch
Canadian Family Physician Sep 2010, 56 (9) 873-879;

Citation Manager Formats

  • BibTeX
  • Bookends
  • EasyBib
  • EndNote (tagged)
  • EndNote 8 (xml)
  • Medlars
  • Mendeley
  • Papers
  • RefWorks Tagged
  • Ref Manager
  • RIS
  • Zotero
Respond to this article
Share
Bariatric surgery
Shahzeer Karmali, Carlene Johnson Stoklossa, Arya Sharma, Janet Stadnyk, Sandra Christiansen, Danielle Cottreau, Daniel W. Birch
Canadian Family Physician Sep 2010, 56 (9) 873-879;
Twitter logo Facebook logo Mendeley logo
  • Tweet Widget
  • Facebook Like
  • Google Plus One

Jump to section

  • Article
    • Abstract
    • Quality of evidence
    • Indications for bariatric surgery
    • Options for bariatric surgery
    • Complications
    • Early complications
    • Late complications
    • Outcomes after surgery
    • Postsurgery follow-up
    • Nutrition and supplementation
    • Conclusion
    • Notes
    • Footnotes
    • References
  • Figures & Data
  • eLetters
  • Info & Metrics
  • PDF

Related Articles

  • No related articles found.
  • PubMed
  • Google Scholar

Cited By...

  • Role of the family doctor in the management of adults with obesity: a scoping review
  • Managing complications associated with laparoscopic Roux-en-Y gastric bypass for morbid obesity
  • Managing obesity in adults in primary care
  • Google Scholar

More in this TOC Section

Practice

  • Determining if and how older patients can safely stay at home with additional services
  • Managing type 2 diabetes in primary care during COVID-19
  • Effectiveness of dermoscopy in skin cancer diagnosis
Show more Practice

Clinical Review

  • Determining if and how older patients can safely stay at home with additional services
  • Managing type 2 diabetes in primary care during COVID-19
  • Effectiveness of dermoscopy in skin cancer diagnosis
Show more Clinical Review

Similar Articles

Navigate

  • Home
  • Current Issue
  • Archive
  • Collections - English
  • Collections - Française

For Authors

  • Authors and Reviewers
  • Submit a Manuscript
  • Permissions
  • Terms of Use

General Information

  • About CFP
  • About the CFPC
  • Advertisers
  • Careers & Locums
  • Editorial Advisory Board
  • Subscribers

Journal Services

  • Email Alerts
  • Twitter
  • LinkedIn
  • Instagram
  • RSS Feeds

Copyright © 2025 by The College of Family Physicians of Canada

Powered by HighWire