Risks of Smoking After Sleeve Gastrectomy and Gastric Bypass
Smoking after bariatric surgery, including sleeve gastrectomy and gastric bypass, significantly increases the risk of serious complications. This applies to all forms of smoking, including cigarettes, electronic cigarettes (vaping), and shisha (hookah).
Even occasional or light smoking can cause severe gastric ulcers after bariatric surgery. Smoking directly affects blood supply to the stomach and the healing of surgical tissues, increasing the likelihood of postoperative complications.
Complications of Smoking After Bariatric Surgery
Smoking after bariatric surgery may lead to several serious complications, including:
- Increased risk of gastric leak
- Higher risk of gastrointestinal bleeding
- Development or worsening of gastroesophageal reflux disease (GERD)
- Chronic Helicobacter pylori infection
- Difficulty eating or drinking
- Severe gastric ulcers
- Narrowing of the gastric outlet
- Persistent vomiting
- Dehydration
- Episodes of fainting
Smoking may also lead to late complications for months or even years after surgery, such as:
- Hiatal hernia
- Chronic gastric ulcers
- Gastric narrowing or torsion
In some cases, these complications may require corrective surgery or conversion to a Roux-en-Y gastric bypass.
When Should Patients Stop Smoking Before Bariatric Surgery?
Bariatric surgeons strongly recommend complete cessation of smoking before and after bariatric surgery, particularly avoiding cigarettes, shisha, and electronic cigarettes.
At minimum, patients should:
- Stop smoking at least two weeks before surgery
- Avoid smoking for at least six weeks after surgery
However, it is important to understand that long-term complications related to smoking may still occur even after cessation.
Patients Who Should Not Undergo Bariatric Surgery
Bariatric surgery should not be performed in patients who:
- Smoke cannabis
- Use Opioids
This restriction applies even if the patient is not in an addiction stage, because these substances are associated with a significantly increased risk of postoperative gastric leaks and serious complications.
Recommendations from the American Society for Metabolic and Bariatric Surgery (ASMBS)
The American Society for Metabolic and Bariatric Surgery (ASMBS) recommends complete smoking cessation before and after bariatric surgery due to the increased risk of postoperative complications.
Dr. Ahmed Shinkar
Consultant of Bariatric and Laparoscopic Surgery