Les Contre-Indications de la Chirurgie Bariatrique

Abstract

Contra indications to bariatric surgery are numerous and must be recognized under penalty of failure of this surgery. Psychiatric diseases pro fit as well as possible from a precise and repeated evaluation; they lead to many contraindications however not always final; the addictions (alcoholism and drug-addiction) are clearly contraindications; gastro-esophageal reflux is a relative contra indication to certain types of restrictive procedures but gastro-enterologic morphological explorations make it possible to discuss on a case-by-case basis; the age rep resents a relative contra indication particularly to the extrems: for the adolescent, the surgery remains still debatable, but evolutions are awaited; for a patient older than 60, it is the analysis of the benefit report/ratio risks which makes it possible to decide. Abdominal pathologies, such as inflammatory bowel diseases, which are bigger contraindications to gastric bypass, or antecedents of abdominal surgery, are situations that must be discussed in a precise way, at best within a multidisciplinary team invested in a global take over of obesity.

Keywords: Bariatric surgery, Contraindications, Psychiatric diseases, Gastro-esophageal reflux, Gastric bypass, Gastric banding