Risk factors for complications of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Piotr Major; Michał Wysocki; Michał Pędziwiatr; Magdalena Pisarska; Jadwiga Dworak; Piotr Małczak; Andrzej Budzyński

doi:10.1016/j.ijsu.2016.12.012

Risk factors for complications of laparoscopic sleeve gastrectomy and laparoscopic Roux-en-Y gastric bypass

Int J Surg. 2017 Jan:37:71-78. doi: 10.1016/j.ijsu.2016.12.012. Epub 2016 Dec 10.

Authors

Piotr Major¹, Michał Wysocki², Michał Pędziwiatr³, Magdalena Pisarska⁴, Jadwiga Dworak⁵, Piotr Małczak⁶, Andrzej Budzyński⁷

Affiliations

¹ 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: majorpiotr@gmail.com.
² Students' Scientific Group at 2nd Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: michal92wysocki@gmail.com.
³ 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: michal.pedziwiatr@uj.edu.pl.
⁴ 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: magdalenapisarska@interia.pl.
⁵ 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: jadwigadworak@gmail.com.
⁶ 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: pmmalczak@gmail.com.
⁷ 2(nd) Department of Surgery, Jagiellonian University Medical College, Kopernika 21 St., 31-501, Kraków, Poland. Electronic address: andrzej.budzynski@uj.edu.pl.

PMID: 27956112
DOI: 10.1016/j.ijsu.2016.12.012

Abstract

Background: Although bariatric procedures are considered safe, yet still they involve a risk of possible perioperative complications. Identification of risk factors for complications would allow for appropriate preoperative optimization of the patient, as well as reasonable postoperative care and early diagnosis and treatment of possible complications. The aim of this study was to determine the risk factors for perioperative complications after laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).

Material and methods: A retrospective analysis of prospectively collected data of patients operated for morbid obesity. Regarding postoperative complications defined as adverse events occurring within 30 days of the procedure. Factors associated with patient characteristics and those related to the surgical procedure were determined. 408 patients met inclusion criteria and were submitted to surgical treatment. LSG and LRYGB were performed in 233 and 175 patients, respectively.

Results: Complications were observed in 30 (7.3%) patients. The maximum preoperative body weight and BMI, as well as body weight and BMI on the day of surgery were associated with increased complication rate. The type of the procedure did not influence perioperative complications (LRYGB vs. LSG; OR: 1.14; CI: 0.53-2.44; p = 0.74). Although operative time statistically significantly increased the risk of complications, it did not seem clinically relevant (OR: 1.01; CI: 1.00-1.02; p = 0.003). An increase in the number of stapler firings used significantly increased complication rate only in LSG group.

Conclusion: Longer duration of LSG and the increase in the number of stapler firings used during LSG should alert a surgeon to an increased risk of postoperative complications. In patients submitted to LRYGB the risk of possible complications increases with BMI.

Keywords: Gastric bypass; Postoperative complications; Risk factors; Sleeve gastrectomy.

Publication types

Observational Study

MeSH terms

Adult
Body Mass Index
Female
Gastrectomy / adverse effects*
Gastric Bypass / adverse effects*
Humans
Laparoscopy*
Male
Operative Time
Postoperative Complications
Retrospective Studies
Risk Factors
Surgical Stapling