The cause of death of Lisa Marie Presley, which was revealed Thursday to be small bowel obstruction, has drawn attention to the rare risks and long-term complications of bariatric surgery.
The Los Angeles County Medical Examiner’s Office determined that the blockage was caused by adhesions (buildup of scar tissue that causes organ tissue or walls to stick together) that Presley developed after undergoing bariatric surgery ago. years.
Bariatric surgery, a treatment for severe obesity, induces weight loss by modifying the stomach or small intestine to reduce the amount of food the stomach can hold.
Presley, the only child of Elvis and Priscilla Presley, died on January 12 at the age of 54.
Two experts said the news should not cause panic for people who have had bariatric surgery or are considering doing so. Previous research has found that the risk of death associated with the procedure in 10 years it is minimal. And in the short term after such surgery, the risk of death is about 0.08%, or less than 1 in 1,000, according to one study 2021 based on data from several million patients.
“It is a terrible tragedy what happened to her and her family, but overall, bariatric surgery is extremely safe,” Dr. Marina Kurian, president of the American Society for Metabolic and Bariatric Surgery, said of Presley’s death. . “The risks of these kinds of things happening are very low.”
Dr. Ali Aminian, director of the Cleveland Clinic’s Metabolic and Bariatric Institute, estimated that only about 3% of patients who undergo bariatric surgery experience long-term complications, with the main risk being malnutrition. The long-term risk of developing intestinal obstruction in all types of abdominal surgeries is about 1% to 2%, he said.
Also, Aminian said, surgical techniques have improved significantly in the last decade.
“We have learned how to better align the intestine, how to better connect the intestine, decrease the risk of scarring,” he said. «The way we do gastric bypass now in 2023 is totally different than the way we did the procedure 10 years ago, so we’ve learned how to do a better procedure, which is much safer now.»
Although the scar tissue that forms after abdominal surgeries does not usually cause health problems, it can sometimes cause the intestines to become twisted or adhesions to form, which can cause intestinal obstructions. according to the Cleveland Clinic.
Symptoms of such an obstruction include abdominal pain, nausea, and vomiting. Aminian said that patients experiencing these signs should seek medical attention. The problem sometimes resolves itself, but in some cases, it may require surgery to clean up scar tissue or remove the diseased part of the intestine, she said.
Presley had complained of abdominal pain in the months before and on the morning of her death, according to the autopsy report and a coroner’s investigator. He was also found to have «therapeutic levels» of the pain reliever oxycodone in his blood, among other substances, although those did not contribute to his death, according to the report.
“I think sometimes opioids can mask some of the symptoms,” Kurian said. «The message really is that if you have abdominal pain and you’ve had any type of abdominal surgery, you really need to be evaluated for that.»
Bariatric surgery was performed more than 260,000 times in the US in 2021, according to an estimate by the American Society for Metabolic and Bariatric Surgery. More than half of the procedures performed that year were gastric sleeve surgery, which removes about 80% of the stomach. Meanwhile, gastric band surgery implants a medical band to reduce the size of the stomach, and duodenal switch surgery also involves dividing the small intestine.
Details in Presley’s autopsy report suggest he underwent duodenal switch surgery, Kurian said, which accounted for less than 3% of bariatric procedures performed in 2021, according to society data.
Aminian emphasized that bariatric surgery can improve the health of many patients, including reducing the risks of heart disease, kidney failure, diabetes, high blood pressure and cancer. Some investigation has discovered that bariatric surgery can reduce the risk of death overall in adults with obesity; to 2015 study found that some patients could add an additional six years to their life expectancy after surgery.
«Surgery can reverse all the health consequences of obesity, so those are the benefits,» he said. «Just like any other type of medical intervention, any type of surgical intervention, there are some risks, but the benefits outweigh the risks.»