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Perioperative mortality in bariatric surgery: meta-analysis.
A G N Robertson1, T Wiggins2, F P Robertson3
1Victoria Hospital Kirkcaldy, NHS Fife, Kirkcaldy, UK.
The British Journal of Surgery
|July 23, 2021
Summary
Bariatric surgery is safe, with a low overall perioperative mortality rate of 0.08%. Different bariatric procedures show varying risks, with duodenal switch having the highest mortality.
Area of Science:
- Metabolic and Bariatric Surgery
- Surgical Outcomes Research
- Obesity Treatment Efficacy
Background:
- Bariatric surgery is effective for severe obesity but underutilized.
- Perceived surgical risk is a barrier to patient uptake.
- This study quantifies perioperative mortality to address safety concerns.
Purpose of the Study:
- To determine the perioperative mortality rates of bariatric surgery.
- To compare mortality across different bariatric operation types.
- To evaluate mortality based on data sources and study designs.
Main Methods:
- Systematic literature search (2014-2020) of Ovid MEDLINE, Embase, and Cochrane.
- Included studies with >= 1000 patients reporting short-term mortality.
- Meta-analysis of data from 58 studies (>3.6 million patients).
Main Results:
- Overall perioperative mortality was 0.08% (95% CI 0.06-0.10).
- No significant differences in mortality across study types (RCTs, registries, databases).
- Mortality varied by procedure: gastric band (0.03%) to duodenal switch (0.41%).
Conclusions:
- Bariatric surgery demonstrates a low perioperative mortality.
- The safety profile supports wider consideration for eligible patients.
- Procedure selection influences risk, with duodenal switch being highest.
