Complications After Bariatric Surgery: Insights from a 14-Year Single-Institutional Study Without Fistula

Area of Science:

• Metabolic and Bariatric Surgery
• Surgical Outcomes Research
• Public Health and Obesity

Background:

• Obesity presents a significant global healthcare challenge, necessitating effective long-term management strategies.
• Bariatric surgery is the most effective long-term treatment for morbid obesity.
• Successful bariatric surgery outcomes depend on high-quality perioperative management and specialized institutional expertise.

Purpose of the Study:

• To analyze 14 years of bariatric surgical activity at a university-based Center of Excellence.
• To evaluate complication rates and safety outcomes in a large cohort of bariatric surgery patients.
• To assess the impact of a multidisciplinary, protocol-driven approach on bariatric surgery results.

Main Methods:

• A 14-year prospective cohort analysis of bariatric procedures (June 2012-June 2025).
• Patient eligibility determined by American Society for Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) guidelines.
• Standardized preoperative evaluation by a multidisciplinary team.

Main Results:

• 1010 patients underwent bariatric surgery with a mean age of 39 years; 72% were female.
• Overall complication rate was 6.73% (68 patients), with 2.77% early and 3.96% late complications.
• Notably, zero postoperative fistulas and zero deaths were recorded over the 14-year study period.

Conclusions:

• Long-term data from over 1000 bariatric cases confirm the safety and effectiveness of a multidisciplinary, protocol-driven approach.
• The absence of postoperative fistulas and mortality emphasizes the critical role of institutional experience and standardized perioperative care.
• This study supports the value of specialized centers in achieving excellent outcomes in bariatric surgery.