In an analysis of the complication rate after bariatric surgery, Schwartz et al. analyzed 600 laparoscopic RYGBs and found the overall complication rate approached 26 percent.12 One of the main predictors of complications is the experience of the surgeon.13 In fact, the American Society of Bariatric Surgeons recommends that a surgeon perform 100 procedures before technical expertise is obtained. The higher the weight (body-mass index > 55 kg/m2), the more likely there will be complications. Males over 50 years of age are at increased risk of complications. The presence of hypertension and sleep apnea will increase the likelihood of complications. Interestingly, the presence of diabetes is not a predictor of complications.
The presence of psychiatric illness is believed to be a predictor of complications. The data supporting this conclusion is discordant. In some series, severe psychiatric illness is associated with poor outcome, such as inadequate weight loss, chronic
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