Ann Surg Treat Res.  2018 Aug;95(2):100-110. 10.4174/astr.2018.95.2.100.

Risk factors for early postoperative complications after bariatric surgery

• Husain F
• Jeong IH
• Spight D
• Wolfe B
• Mattar SG

• KMID: 2417776
• DOI: http://doi.org/10.4174/astr.2018.95.2.100

Abstract

PURPOSE
Vertical sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB) are currently the most common bariatric procedures. Although the safety of these operations has markedly improved, there continues to be a certain rate of complications. Such adverse events can have a significant deleterious effect on the outcome of these procedures and represent a costly burden on patients and society at large. A better understanding of these complications and their predictive factors may help ameliorate and optimize outcomes.
METHODS
Seven hundred seventy-two consecutive patients who underwent SG or RYGB for morbid obesity between January 2011 and October 2015, in the Division of Bariatric Surgery at a tertiary institution, were included through retrospective review of the medical database. The complications were categorized and evaluated according to severity using the Clavien-Dindo classification system. Significant risk factors were evaluated by binary logistic regression to identify independent predictors and analyzed to identify their relationship with the type of complication.
RESULTS
Independent predictors of severe complication after these procedures included male gender, open and revisional surgery, hypertension, and hypoalbuminemia. Hypoalbuminemia had significant associations with occurrence of deep surgical site infection and leak. Open surgery had significant associations with occurrence of superficial and deep surgical site infection and respiratory complications. Independent predictors of severe complication after laparoscopic primary RYGB included previous abdominal surgery. Previous abdominal surgery had significant associations with deep surgical site infection and leak.
CONCLUSION
Recognition and optimization of these risk factors would be valuable in operative risk prediction before bariatric surgery.

Keyword

Bariatric surgery; Gastric bypass; Postoperative complications

MeSH Terms

Bariatric Surgery*
Classification
Gastrectomy
Gastric Bypass
Humans
Hypertension
Hypoalbuminemia
Logistic Models
Male
Obesity, Morbid
Postoperative Complications*
Retrospective Studies
Risk Factors*
Surgical Wound Infection

Figure

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  Fig. 1 Relationship between preoperative serum albumin level and type of complication.

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  Fig. 2 The type of complication according to surgical approach.

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  Fig. 3 Relationship between previsous abdominal surgery and type of complication after laparoscopic Roux-en-Y gastric bypass.

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