Procedure-related morbidity in bariatric surgery: a retrospective short- and mid-term follow-up of a single institution of the American College of Surgeons Bariatric Surgery Centers of Excellence

Abraham Fridman, Rena Moon, Yaniv Cozacov, Carolina Ampudia, Emanuele Lo Menzo, Samuel Szomstein, Raul J Rosenthal
Journal of the American College of Surgeons 2013, 217 (4): 614-20

BACKGROUND: Our objective was to ascertain procedure-related morbidity among laparoscopic Roux-en-Y gastric bypass (LRYGB), laparoscopic sleeve gastrectomy (LSG), and laparoscopic adjustable gastric banding (LAGB) patients. These are the 3 most common bariatric procedures performed worldwide. We reviewed our experience since the introduction of LSG and compared the procedure-related morbidity among all 3 procedures.

STUDY DESIGN: We conducted a retrospective review of a prospectively collected database of all morbidly obese patients who underwent bariatric surgery between the years 2005 and 2011. We identified and compared complications, mortality, readmissions, and reoperations in patients who underwent LRYGB, LAGB, and LSG.

RESULTS: A total of 2,199 bariatric procedures were performed during this period of time. Of those procedures, 1,327 were LRYGB, 619 were LSG, and 253 were LAGB. Perioperative mortality was not applicable for all 3 procedures. The leak rate was 0.5% for LRYGB and 0.3% for LSG, and was not applicable for LAGB. The average number of readmissions postoperatively was less than 2 times for all 3 procedures: LRYGB 1.96 times, LSG 1.49 times, and LAGB 1.54 times. The percentages of procedures requiring reoperations due to complications or failures were 14.6% in the LAGB group, 6.6% in the LRYGB group, and 1.8% in the LSG group.

CONCLUSIONS: In short- and mid-term follow-up, LSG appears to have the lowest procedure-related morbidity when compared with LRYGB and LAGB.

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