Chirurgie bariatrique : techniques chirurgicales et leurs complications

Key points Bariatric surgery is the only treatment permitting significant and long lasting results for patients suffering from morbid obesity. Indications are BMI > 40 kg/m 2 or BMI > 35 kg/m 2 associated with one or multiples comorbidities. In all cases, a multidisciplinary approach is required. Laparoscopic surgery because of its mini-invasive nature is a significant improvement for early and late postoperative courses. Adjustable gastric banding, gastric by-pass, sleeve gastrectomy, bilio-pancreatic diversions are in this order the most frequent bariatric procedures performed in France. Severe and early surgical complications are dominated by occlusions and anastomotic leakages. Late complications are dominated by small bowel occlusions. Early medical complications are thrombo-embolism manifestations. Late medical complications are vitamin and trace elements deficiencies. Severe complications are due to pauci-symptomaticity of patients and their poor clinical status. Every practitioner taking care of these patients have to know all principles, specificity and complications of this kind of surgery.