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Procedure-Specific Early Complications Following Bariatric Surgery: A High-Volume Single-Institution Analysis.

Kamal Abi Mosleh1,2, Noura Jawhar1, Yara Salameh3

  • 1Department of Surgery.

Surgical Laparoscopy, Endoscopy & Percutaneous Techniques
|September 22, 2025
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Summary

Early complications after bariatric surgery vary by procedure. Duodenal switch (DS) had the highest overall rate, while Roux-en-Y gastric bypass (RYGB) had more major complications, despite generally safe outcomes.

Keywords:
anastomotic leakanastomotic stricturebariatric surgeryduodenal switchearly complicationsroux-en-Y gastric bypasssleeve gastrectomy

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Area of Science:

  • Bariatric surgery outcomes research
  • Surgical complication analysis
  • Obesity treatment safety

Background:

  • Metabolic and bariatric surgery (MBS) is a key treatment for severe obesity and related conditions.
  • Early postoperative complications are crucial for assessing MBS safety and resource use.
  • Previous large studies lack detail on specific procedure complications.

Purpose of the Study:

  • To analyze 30-day postoperative complications for sleeve gastrectomy (SG), Roux-en-Y gastric bypass (RYGB), and duodenal switch (DS).
  • To compare complication incidence, severity, and types across these primary bariatric procedures.
  • To identify predictors of early complications in a high-volume academic center setting.

Main Methods:

  • Retrospective cohort study of 2190 adult patients undergoing primary laparoscopic SG, RYGB, or DS (2008-2024).
  • Complications within 30 days were identified via chart review and graded using Clavien-Dindo system.
  • Multivariable logistic regression analyzed predictors of overall and major complications.

Main Results:

  • 18.9% of patients experienced early complications (467 events total).
  • Duodenal switch (DS) had the highest complication rate (29.3%), followed by RYGB (18.4%) and SG (17.5%).
  • RYGB showed a higher burden of major complications (e.g., strictures, bleeding, leaks); predictors included venous stasis, renal insufficiency, and diabetes.

Conclusions:

  • Procedure type significantly impacts early complication profiles after MBS.
  • DS had the highest overall early complication rate; RYGB presented a greater risk of major complications.
  • Findings highlight the importance of institutional experience in understanding and managing bariatric surgery outcomes.