American College Of Surgeons - Inspiring Quality: Highest Standards, Better Outcomes

COVID-19 Guidelines for Triage of Metabolic and Bariatric Surgery Patients

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Emergency

(Needs immediate action; life threatening or permanent organ damage)

  • Patients in hemorrhagic shock
  • Patients in septic shock
  • Necrotizing soft tissue infections
  • Perforated viscus
  • Airway emergencies
  • Risk of Ischemic bowel
  • Specific Bariatric: Perforated marginal ulcer, bleeding, anastomatic or staple-line leak, obstruction particularly internal hernia, gastric band perforation or prolapse

Urgent

(Needs surgery; may be delayed by a few days/weeks)

  • Bariatric: revisions for dysphagia, severe gerd, pain, dehydration/malnutrition, slipped band, anastomotic strictures at risk for aspiration
  • Primary cases for patients pending surgery requiring preop weight loss ie transplant, etc.

Elective

(May be delayed for months without threat to life or organ damage)

  • Bariatric: primary gastric bypass, sleeve, duodenal switch, gastric band
  • Revisions for weight gain

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