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Published on: November 10, 2018
Fast-track laparoscopic bariatric surgery: a systematic review
Jessie A Elliott1, Vanash M Patel, Ali Kirresh
1Department of Surgery and Cancer, Imperial College, London, UK. jelliott@tcd.ie
Updates in Surgery
|February 2, 2013
Summary
Fast-track laparoscopic bariatric surgery, including Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB), is feasible and safe. This approach demonstrates comparable outcomes to conventional care with potential cost savings.
Area of Science:
- Bariatric Surgery
- Minimally Invasive Surgery
- Health Services Research
Background:
- Fast-track protocols aim to reduce hospital stays and costs in bariatric surgery.
- Evidence on the feasibility and safety of fast-track laparoscopic Roux-en-Y gastric bypass (LRYGB) and laparoscopic adjustable gastric banding (LAGB) requires systematic evaluation.
Purpose of the Study:
- To systematically review the literature on fast-track LRYGB and LAGB.
- To determine the feasibility and safety of fast-track laparoscopic bariatric surgery.
Main Methods:
- Systematic literature search of PubMed, EMBASE, and Cochrane Library.
- Inclusion of studies reporting next-day discharge for LRYGB and same-day discharge for LAGB.
- Data extraction on study design, patient selection, perioperative management, outcomes, and follow-up.
Main Results:
- Review included 13 studies (level 3b or 4 evidence).
- High discharge rates observed: 81-100% for LRYGB (next-day) and 76-98% for LAGB (same-day).
- Complication, readmission, and mortality rates were comparable to conventional care.
Conclusions:
- Fast-track management for LRYGB and LAGB is feasible.
- Careful patient selection, high-volume centers, and follow-up pathways support favorable outcomes and reduced costs.
- Further research is needed to confirm safety for widespread adoption and cost-effectiveness.
