Does intraoperative endoscopy decrease complications after bariatric surgery? Analysis of American College of...

Area of Science:

• Bariatric Surgery
• Surgical Endoscopy
• Patient Outcomes

Background:

• Serious complications such as sepsis, bleeding, and stenosis can occur after bariatric surgery.
• These complications can be fatal if not managed promptly.
• Intraoperative endoscopy (IOE) is a potential tool to mitigate these risks.

Purpose of the Study:

• To compare major postoperative complications in patients who underwent bariatric surgery with and without IOE.
• To evaluate the impact of IOE on specific adverse events following LSG and LRYGB.

Main Methods:

• Utilized data from the American College of Surgeons National Surgical Quality Improvement Program (2011-2016).
• Included patients who underwent laparoscopic sleeve gastrectomy (LSG) and laparoscopic Roux-en-Y gastric bypass (LRYGB).
• Compared outcomes between IOE and non-IOE groups using bivariate and multivariate analyses, focusing on 30-day outcomes.

Main Results:

• IOE was used in 17.9% of LSG and 19.7% of LRYGB cases.
• Endoscopy-assisted LSG showed decreased rates of sepsis, unplanned reoperations, prolonged hospital stay, and composite complications.
• LRYGB patients with IOE experienced a reduced prolonged hospital stay, with other outcomes being similar between groups.

Conclusions:

• Intraoperative endoscopy is underutilized in bariatric procedures.
• IOE is associated with reduced postoperative complications, especially sepsis and reoperations, after LSG.
• Further multicenter prospective studies are warranted to investigate the intermediate and long-term benefits of IOE in bariatric surgery.