Rate of Major Complications Low After Bariatric Surgery
The rates of myocardial infarction and pulmonary embolism were higher for gastric bypass than adjustable gastric banding or sleeve gastrectomy.
HealthDay News — The rates of 3 major complications at less than 30 days after bariatric surgery are low and vary among surgical procedures, according to research published online in Obesity Reviews.
Su-Hsin Chang, PhD, from the Washington University School of Medicine in St. Louis, and colleagues examined <30-day major complications associated with bariatric procedures. Data were included from 71 studies conducted in the United States from 2003 to 2014 and involving 107,874 patients undergoing gastric bypass, adjustable gastric banding, or sleeve gastrectomy.
The researchers found that the anastomotic leak rate was 1.15%, myocardial infarction rate was 0.37%, and pulmonary embolism rate was 1.17% at less than 30 days. For all patients, the mortality rate after anastomotic leak, myocardial infarction, and pulmonary embolism was 0.12%, 0.37%, and 0.18%, respectively.
At less than 30 days after surgery, the rate of anastomotic leak was higher for sleeve gastrectomy (1.21; 95% CI, 0.23% to 2.19%) than gastric bypass (1.14; 95% CI, 0.84 to 1.43%); the rates of myocardial infarction and pulmonary embolism were higher for gastric bypass than adjustable gastric banding or sleeve gastrectomy. The quality of complication reporting was lower than reporting of other outcomes.
"Future studies reporting complications after bariatric surgery should report both occurrence and non-occurrence within a definitive time frame to help evaluate risks of bariatric surgery and allow for valid comparison between surgical procedures," the authors write.
Chang SH, Freeman NLB, Lee JA, et al. Early major complications after bariatric surgery in the USA, 2003-2014: a systematic review and meta-analysis [published online December 20, 2017]. Obesity Rev. doi: 10.1111/obr.12647