Background

Bariatric surgery is a safe procedure with low rates of complications. Little is known regarding the impact of surgical complications on bariatric surgery success. Here, we compare the outcomes of bariatric surgery between patients who have encountered surgical complications (C), and those who have not (NC).

Methods

A retrospective study of 2293 obese patients that underwent gastric bypass, sleeve gastrectomy or gastric band placement between 2002 and 2016 was completed. Patients with surgical complications within 90 days of surgery were identified. Demographics data was collected preoperatively. Weight loss and laboratory values were collected preoperatively and at 3, 6, and 12 months postoperatively. Data were analyzed using Student's t-tests and chi-square test through GraphPad Prism v7.0.

Results

161 out of 2293 (7.0%) patients were identified with surgical complications. These patients suffered from leaks (n= 9, 0.39%), bleeds (n= 50, 2.18%), cerebrovascular accidents (n= 2, 0.09%), pulmonary embolisms (n= 14, 0.61%), wound infections (n= 26, 1.13%), myocardial infarctions (n= 2, 0.09%), intra-abdominal abscess (n=1. 0.04%), vitamin deficiency (n=22, 0.96%), arrhythmias (n= 8, 0.35%), pneumonia (n= 14, 0.61%), bowel obstruction (n= 12, 0.52%), and ulcers/strictures (n=20, 0.87%). Patients in the complications cohort had higher systolic blood pressure (139.8±1.25 vs. 134.8±0.36, p=0.0002), were comprised of more males (26.71% vs. 19.93%, p=0.0398), had longer operation times (175.7±5.26 vs. 149.8±1.271 minutes, p<0.0001), and were more likely to have undergone gastric bypasses (91.3% vs. 69.8%, p<0.0001) than patients in the no complications cohort. Both cohorts lost a statistically significant amount of their excess weight at 3 (C: 40.1±1.15%, NC: 39.3±0.35%), 6 (C: 57.6±1.46%, NC: 56.3±0.50%), and 12 months (C: 68.4±2.09%, NC: 68.5±0.72%) following surgery (all p<0.0001) and witnessed improvements in risk factors and markers such as A1C (C: 6.4±0.1% to 5.6±0.08%, NC: 6.3±0.03% to 5.5±0.02%), HDL (C: 44.7±1.0 to 52.9±1.5 mg/dL, NC: 45.8±0.4 to 55.9±0.5 mg/dL), LDL (C: 105.8±3.0 to 88.1±2.7 mg/dL, NC: 110.5±1.0 to 95.1±0.9 mg/dL), Cholesterol (C: 174.2±3.6 to 159.6±3.3 mg/dL, NC: 182.7±0.9 to 168.6±1.1 mg/dL), and C-Reactive Protein (C: 9.3±0.8 to 2.2±0.4 mg/dL, NC: 9.8±0.2 to 3.2±0.2 mg/dL) at 12 months (all p<0.05). There were no significant differences between the two cohorts in weight loss, risk factor improvement, and comorbidity (diabetes, hypertension, and hyperlipidemia) resolution at 3, 6, and 12 months postoperatively (all p>0.05).

Conclusions

Surgical complications following bariatric surgery do not seem to reduce the success of surgery.