Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
Journal of Gastrointestinal Surgery
Published in: Journal of Gastrointestinal Surgery 7/2019

01-07-2019 | Portal Vein Thrombosis | 2018 SSAT Plenary Presentation

Trends in Utilization and Relative Complication Rates of Bariatric Procedures

Authors: Ann Y. Chung, Paula D. Strassle, Francisco Schlottmann, Marco G. Patti, Meredith C. Duke, Timothy M. Farrell

Published in: Journal of Gastrointestinal Surgery | Issue 7/2019

Login to get access

Abstract

Background

Laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding have been popular alternatives to laparoscopic Roux-en-Y gastric bypass due to their technical ease and lower complication rates. Comprehensive longitudinal data are necessary to guide selection of the appropriate bariatric procedures for individual patients.

Methods

We used the Truven Heath Analytics MarketScan® database between 2000 and 2015 to identify patients undergoing bariatric surgery. Kaplan-Meier and Cox proportional hazard regression analyses were performed to compare complication rates between laparoscopic gastric bypass and laparoscopic sleeve gastrectomy, as well as between laparoscopic gastric bypass and laparoscopic adjustable gastric banding.

Results

256,830 individuals met search criteria. By 2015, laparoscopic sleeve gastrectomy was the most commonly performed bariatric procedure followed by laparoscopic gastric bypass and then laparoscopic adjustable gastric banding. Overall, laparoscopic sleeve gastrectomy and laparoscopic adjustable gastric banding had fewer complications relative to laparoscopic gastric bypass with the exceptions of heartburn, gastritis, and portal vein thrombosis following sleeve gastrectomy and heartburn and dysphagia following adjustable gastric banding.

Conclusion

Laparoscopic sleeve gastrectomy is now the most commonly performed bariatric procedure in the USA. It is reassuring that its overall postoperative complication rates are lower relative to laparoscopic gastric bypass.
Literature
1.
Ogden CL, Carroll MD, Fryar CD, Flegal KM. Prevalence of Obesity Among Adults and Youth: United States, 2011-2014. National Center for Health Statistics (NCHS) Data Brief. Centers for Disease Control and Prevention. No. 219, November 2015.
2.
English WJ, DeMaria EJ, Brethauer SA, Mattar SG, Rosenthal RJ, Morton JM. American Society for Metabolic and Bariatric Surgery estimation of metabolic and bariatric procedures performed in the United States in 2016. Surgery for Obesity and Related Diseases. 14 (2018) 259–263.CrossRefPubMed
3.
Salminen P, Helmio M, Ovaska J, Juuti A, Leivonen M, Peromaa-Haavisto P, Hurme S, Soinio M, Nuutila P, Victorzon M. Effect of Laparoscopic Sleeve Gastrectomy vs Laparoscopic Roux-en-Y Gastric Bypass on Weight Loss at 5 Years Among Patients with Morbid Obesity: The SLEEVEPASS Randomized Clinical Trial. The Journal of the American Medical Association. 2018;319(3):241–254.CrossRefPubMed
4.
Peterli R, Borbely Y, Kern B, Gass M, Peters T, Thurnheer M, Schultes B, Laederach K, Bueter M, Schiesser M. Early Results of the Swiss Multicenter Bypass or Sleeve Study (SM-BOSS): A Prospective Randomized Trial Comparing Laparoscopic Sleeve Gastrectomy and Roux-en-Y Gastric Bypass. Annals of Surgery. 2013;258(5):690–695.CrossRefPubMedPubMedCentral
5.
Arterburn D, Gupta A. Comparing the Outcomes of Sleeve Gastrectomy and Roux-en-Y Gastric Bypass for Severe Obesity. The Journal of the American Medical Association. 2018;319(3):235–237.CrossRefPubMed
6.
Puzziferri N, Roshek TB, Mayo HG, Gallagher R, Belle SH, Livingston EH. Long-term Follow-up After Bariatric Surgery: A Systematic Review. The Journal of the American Medical Association. 2014;312(9):934–942.CrossRefPubMed
7.
Carlin AM, Zeni TM, English WJ, Hawasli AA, Genaw JA, Krause KR, Schram JL, Kole KL, Finks JF, Birkmeyer JD, Share D, Birkmeyer NJO. The Comparative Effectiveness of Sleeve Gastrectomy, Gastric Bypass, and Adjustable Gastric Banding Procedures for the Treatment of Morbid Obesity. Annals of Surgery. 2013;257(5):791–797.CrossRefPubMed
8.
Tice JA, Karliner L, Walsh J, Petersen AJ, Feldman MD. Gastric Banding or Bypass? A Systematic Review Comparing the Two Most Popular Bariatric Procedures. The American Journal of Medicine. 2008;121(10):885–893.CrossRefPubMed
9.
Morton J, Sherif B, Winegar D, Ngyuen N, Ponce J, Blackstone R. National Comparisons of Bariatric Surgery Safety and Efficacy: Findings from the BOLD Database 2007-2010. American Society for Metabolic & Bariatric Surgery.
10.
Chang SH, Freeman NLB, Lee JA, Stoll CRT, Calhoun AJ, Eagon JC, Colditz GA. Early Major Complications after Bariatric Surgery in the USA, 2003-2014: A Systematic Review and Meta-Analysis. Obesity Reviews. 2018;19(4):529–537.CrossRefPubMed
11.
Chen SY, Stem M, Schweitzer MA, Magnuson TH, Lidor AO. Assessment of postdischarge complications after bariatric surgery: A National Surgical Quality Improvement Program analysis. Surgery. 2015;158(3):777–786.CrossRefPubMed
12.
Deyo RA, Cherkin DC, Ciol MA. Adapting a clinical comorbidity index for use with ICD-9-CM administrative databases. Journal of Clinical Epidemiology. 1992;45(6):613–619.CrossRefPubMed
13.
Cole SR, Hernan MA. Adjusted survival curves with inverse probability weights. Computer Methods and Programs in Biomedicine. 2004,75(1):45–49.CrossRefPubMed
14.
15.
Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obesity Surgery. 1998; 8: 267–282.CrossRefPubMed
16.
Marceau P, Biron S, Bourque RA, Potvin M, Hould FS, Simard S. Biliopancreatic Diversion with a New Type of Gastrectomy. Obesity Surgery. 1993;3(1):29–35.CrossRefPubMed
17.
Lancaster RT, Hutter MM. Bands and bypasses: 30-day morbidity and mortality of bariatric surgical procedures as assessed by prospective, multi-center, risk-adjusted ACS-NSQIP data. Surgical Endoscopy. 2008;22:2554–2563.CrossRefPubMed
18.
Kodner C, Hartmand DR. Complications of Adjustable Gastric Banding Surgery for Obesity. American Family Physician. 2014;89(10):813–818.PubMed
19.
Dogan K, Gadiot RPM, Aarts EO, Betzel B, van Laarhoven CJHM, Biter LU, Mannaerts GHH, Aufenacker TJ, Janssen IMC, Berends FJ. Effectiveness and Safety of Sleeve Gastrectomy, Gastric Bypass, and Adjustable Gastric Banding in Morbidly Obese Patients: a Multicenter, Retrospective, Matched Cohort Study. Obesity Surgery. 2015;25:1110–1118.CrossRefPubMed
20.
Rebecchi F, Allaix ME, Giaccone C, Ugliono E, Scozzari G, Morino M. Gastroesophageal Reflux Disease and Laparoscopic Sleeve Gastrectomy A Physiopathologic Evaluation. Annals of Surgery. 2014;260(5):909–915.CrossRefPubMed
21.
22.
Goitein D, Raziel A, Szold A, Sakran N. Assessment of perioperative complications following primary bariatric surgery according to the Clavien-Dindo classification: comparison of sleeve gastrectomy and Roux-en-Y gastric bypass. Surgical Endoscopy. 2016;30:273–278.CrossRefPubMed
23.
Nimeri A, Ibrahim M, Maasher A, Al Hadad M. Management Algorithm for Leaks Following Laparoscopic Sleeve Gastrectomy. Obesity Surgery. 2016;26(1):21–25.CrossRefPubMed
24.
Souto-Rodríguez R, Alvarez-Sánchez MV. Endoluminal solutions to bariatric surgery complications: A review with a focus on technical aspects and results. World Journal of Gastrointestinal Endoscopy. 2017;9(3):105.CrossRefPubMedPubMedCentral
25.
Shoar S, Poliakin L, Khorgami Z, Rubenstein R, El-Matbouly M, Levin JL, Saber AA. Efficacy and Safety of the Over-the-Scope Clip (OTSC) System in the Management of Leak and Fistula After Laparoscopic Sleeve Gastrectomy: A Systematic Review. Obesity Surgery. 2017;27:2410–2418.CrossRefPubMed
26.
Smallwood NR, Fleshman JW, Leeds SG, Burdick JS. The use of endoluminal vacuum (E-Vac) therapy in the management of upper gastrointestinal leaks and perforations. Surgical Endoscopy. 2016;30(6):2473–80.CrossRefPubMed
27.
Papavramidis ST, Eleftheriadis EE, Papavramidis TS, Kotzampassi KE, Gamvros OG. Endoscopic management of gastrocutaneous fistula after bariatric surgery by using a fibrin sealant. Gastrointestinal Endoscopy. 2004;59(2):296–300.CrossRefPubMed
28.
Parikh A, Alley JB, Petersen RM, Harnisch MC, Pfluke JM, Tapper DM, Fenton SJ. Management Options for Symptomatic Stenosis After Laparoscopic Sleeve Gastrectomy in the Morbidly Obeses. Surgical Endoscopy 2012;(26):738–746.CrossRefPubMed
29.
Shnell M, Fishman S, Eldar S, Goiten D, Santo E. Balloon Dilatation for Symptomatic Gastric Sleeve Stricture. Gastrointestinal Endoscopy. 2014;73:521–524.CrossRef
30.
Campanile FC, Boru CE, Rizzello M, Puzziello A, Copaescu C, Cavallaro G, Silecchia G. Acute Complications after Laparoscopic Bariatric Procedures: Update for the General Surgeon. Langenbeck’s Archives of Surgery. 2013;398(5):669–686.CrossRefPubMed
31.
Boules M, Chang J, Haskins IN, Sharma G, Froylich D, El-Hayek K, Rodriguez J, Kroh M. Endoscopic management of post-bariatric surgery complications. World Journal of Gastrointestinal Endoscopy. 2016;8(17):591–599.CrossRefPubMedPubMedCentral
32.
Walsh, C, Karmali S. Endoscopic management of bariatric complications: A review and update. World Journal of Gastrointestinal Endoscopy. 2015;7(5):518–523.CrossRefPubMedPubMedCentral
33.
Sakran N, Sherf-Dagan S, Blumenfeld O, Romano-Zelekha O, Raziel A, Keren D, Raz I, Hershko D, Gralnek IM, Shohat T, Goitein D. Incidence and Risk Factors for Mortality Following Bariatric Surgery: a Nationwide Registry Study. Obesity Surgery. 2018 [Epub ahead of print].
Metadata
Title
Trends in Utilization and Relative Complication Rates of Bariatric Procedures
Authors
Ann Y. Chung
Paula D. Strassle
Francisco Schlottmann
Marco G. Patti
Meredith C. Duke
Timothy M. Farrell
Publication date
01-07-2019
Publisher
Springer US
Published in
Journal of Gastrointestinal Surgery / Issue 7/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI
https://doi.org/10.1007/s11605-018-3951-2

Other articles of this Issue 7/2019

Journal of Gastrointestinal Surgery 7/2019 Go to the issue

Original Article

The Influence of Age on Complications and Overall Survival After Ivor Lewis Totally Minimally Invasive Esophagectomy

Original Article

Determinants of Rectal Cancer Patients’ Decisions on Where to Receive Surgery: a Qualitative Analysis

Review Article

Is the Enhanced Recovery After Surgery (ERAS) Program Effective and Safe in Laparoscopic Colorectal Cancer Surgery? A Meta-Analysis of Randomized Controlled Trials

GI Image

Giant Primary Retroperitoneal Dedifferentiated Liposarcoma

Original Article

Preferences for Surveillance of Barrett’s Oesophagus: a Discrete Choice Experiment

Letter to the Editor

Effective and Safe Living Donor Hepatectomy Under Intermittent Inflow Occlusion and Outflow Pressure Control